Cold Dew 寒露 Seasonal Node

I’ve been a bit behind on my blogging, and some may have noticed that I missed one of the key four times of the calendar year – the Autumnal Equinox. That was a few weeks ago in September, so by now I’m late enough I figured I should just move onto the next node (for which I am also a few days late!).

Last week on Friday, October 8th the Cold Dew (Han Lu 寒露) Seasonal Node began. The smaller segments of Cold Dew are Hongyan lai bin 鴻雁來賓 (Swan Geese Come and Stay), Jue ru dashui wei ge 爵入 大水爲蛤 (Siskins Dive Into the Watery Abyss to Become Clams), Ju you huanghua 菊有黃華 (Chrysanthemums Display Yellow Flowers).

Here in the Northeastern United States fall is definitely underway. The leaves are slowly starting to change color and the evening temperatures are steadily dropping. However, one of the weather characteristics of Cold Dew is a significant difference between day and night temperatures. For example, lately the daily highs in northern New Jersey have been hovering near 70 degrees, while evening temperatures are dropping to the 40s. That’s about a 30 degree temperature difference! This time of year people have a hard time dressing appropriately for the temperature because what we feel in the morning is not the same as what we feel in the afternoon. The best solution is layering so that one can adapt to the changing thermometer as the day progresses. This is especially important for the elderly, or for other people who, because of either constitution or illness, have diminished toleration for extremes of temperature.

Because of the gradually cooling temperatures, one of the recommendations for Cold Dew is to avoid overconsumption of cold foods, including for example raw vegetables, iced beverages, or foods eaten right out of the refrigerator. Overconsumption of cold foods, especially in patients with weak Spleen/Stomachs, easily leads to abdominal discomfort or diarrhea. These people should drink warm beverages including for example ginger tea (adding honey to protect against Autumn dryness).

For acupuncturists, this is the time of year to do direct moxa on Zu San Li ST36 for patients in order to warm the center. In my clinic I prefer direct Japanese style rice grain moxa, and I believe that clinically this is the most effective way to do moxibustion on Zu San Li. Alternately, direct moxa can be applied at Huo Fu Hai 33.07. If patients are particularly sensitive to exterior cold, or if they are prone to seasonal allergies and upper respiratory problems, then adopt the strategy of warming the surface. For this needle points such as Ling Gu 22.05 and Dai Bai 22.04, in combination with direct moxibustion at Da Zhui DU14.

One of my favorite things this time of year is apples! All sorts of varieties are now commonly available. According to Chinese medicine apples are sweet and sour and have a slightly cold nature. Therefore, regular consumption helps generate fluids, stop thirst, and moisten the Lungs. Since dryness is the seasonal characteristic of Autumn, these functions make apples great for this time of year. However, since apples are cold, as mentioned above, overconsumption of raw apples can lead to digestive upset for some people. Moderation is always the key.

Like apples, other foods that are slightly moistening or sour can be eaten during Cold Dew, but also like apples they should be eaten in moderation. Moistening and yin nourishing foods include Chinese red dates (da zao 大棗), walnuts, chestnuts, yams, peanuts, Chinese white wood ear mushrooms, and lily bulbs. Slightly sour foods include hawthorn, lemons, grapes, pomelos, grapefruits, star fruits, and other similar fruits.

Here is a traditional recipe for Cold Dew…

Cold Dew Congee 寒露粥

Ingredients:

• 100g Rice

• 30g Lily bulb 百合

• 20g Lotus seeds 蓮子

• 4-6 dried red dates 紅棗

• 10g Gingko nuts 銀杏

• 8-10 cups water

Directions:

1. Put all ingredients into a large pot, bring to rapid boil on high flame

2. As soon as boiling, reduce to medium and simmer for 40 minutes to 1 hour, until rice starts to break up and become oatmeal-like

3. Add sugar, or honey to taste

This recipe moistens the lungs, stops cough, clears the heart, quiets the shen. Being a congee it is also warming and supplementing for the middle jiao.

Additional Nourishing Life 養生 Practices for Cold Dew

Since I practice a lot of acupuncture I’m predisposed to liking Nourishing Life practices that work directly with the channels or acupuncture points. So, I’d like to offer some other ideas we can apply during this seasonal node.

Cold Dew is the segment of the year just after Autumn Equinox. It is a part of the time of year represented by the Xu (戌) Earthly Branch, and the phase Yin Soil (i.e., earth) as the transition period at the end of Autumn heading towards Winter. This is the time associated with the Arm Jueyin Pericardium channel as well as the fifth cervical vertebra.

One of the problems we come up against during Cold Dew is the decreasing temperatures, and especially the increasing gap between day and evening temperatures. Since cold is associated with the Water phase, even though Cold Dew is the Pericardium channel time, the Water phase channels (the Bladder and Kidney) are susceptible to problems. In particular, exposure to cold in the evening can cause stagnation in the Qi and Blood circulation of the upper back, leading to stiffness and tightness or pain. Legs can also be affected, likewise experiencing stiffness or pain. So, with all that in mind, here are some easy Nourishing Life practices for Cold Dew:

Rubbing the Bottom of the Feet: The bottom of the foot is home to the first point on the Kidney Channel, Yong Quan (湧泉穴; KD1). Yong Quan is located just behind the ball of the foot and sometimes it is known as the “Great Medicine” (大藥) at the bottom of the feet. Once or twice a day rub the bottom of the foot over the area of Yong Quan 100 times. This warms and stimulates the Kidney channel, and can be used to treat forgetfulness, insomnia, low back pain, and internal cold.

Soaking the Feet: Soaking the feet in the evening is another excellent way to warm the channels of the feet and legs, and it is a second method of working with Yong Quan. One of my common recommendations for Cold Dew is soaking specifically with Epsom salts. To do this, dissolve Epsom salts in hot water and soak feet each evening for 10-15 minutes. Like the previous method of rubbing the bottom of the feet, soaking warms and stimulates the Kidney channel, and can be used to treat forgetfulness, insomnia, and low back pain. For added therapeutic effect, Chinese herbal formulas can be added to foot soaks based on an individual’s pattern differentiation. For example, patients with Qi vacuity can soak with herbs such as Dang Shen, Huang Qi or Bai Zhu. Patients with Kidney vacuity low back pain or the like can soak with Du Zhong, Xu Duan, and Sang Ji Sheng.

Acupressure at Wei Zhong: Weather change and exposure to cold, as mentioned, can create stiffness in the back or legs. One of the master points for increasing Qi and blood circulation in the back and legs is Wei Zhong (委中穴; BL40), located at the back of the knees. While seated, press deeply into the point on both sides simultaneously, until a slightly sore or numb sensation is felt and hold for a few seconds. Release pressure (one press and release equals one stimulation). Stimulate 25-50 times in a sitting. Optionally, medicated liniment or medicated oils that warm the channels, expel cold, and move the Qi and blood can be used while pressing the point.

Cold Dew Daoyin

Fire Cupping the Upper Back: The last traditional recommendation I’ll offer for Cold Dew is the use of fire cups on the upper back. Fire cupping (火罐) can warm and expel cold, resolve the exterior, and course Qi and quicken blood in the channels. When done on the upper back it relieves stiffness in the muscles as well as prevents colds. However, after cupping, be sure not to leave the area exposed. Common points to cup include Jian Yu (肩髃穴; LI15), Jian Jing (肩井穴; GB21), and Tian Zong (天宗穴; SI13). Another area to cup is the back of the neck, as the fifth cervical vertebra is associated with Cold Dew. Just as with the previous recommendation, cupping can be done after the application of a medicated liniment or oil.

Stay warm, stay healthy, wear your masks, and eat lots of apples!

White Dew 白露 Seasonal Node

Today, Tuesday September 7th is turning out to be a very auspicious day. In the Chinese almanac it is an “Open” (開) day, making it good for all sorts of new beginnings. It is also the first day of the 8th Lunar Month in the Chinese calendar, and the Rosh Hashanah, the Jewish New Year. Today is also the start of the White Dew (Bai Lu 白露) Seasonal Node began. We are now well into Autumn in the Chinese calendar, and the midpoint of Autumn, the equinox, is only about 2 weeks away. Autumn is one of the two Yin seasons (along with Winter), and in Five Phase theory it is associated with the Metal, the Lungs, and the direction West. The name White Dew is a direct reference to Five Phase association of Autumn, as white is the Metal Phase’s color.

According to the Su Wen, the movement of Autumn is the movement of harvest (收). All of nature is now in the stage of slowly winding down; for example, in the last few days I’ve been noticing that the mornings are not quite as bright by the time I’m waking up, and the sun is noticeably setting earlier. The names of the three smaller material manifestations of White Dew reflect harvesting of food for the Winter to come, and the return of birds in their migratory patterns: Hongyan lai 鴻雁來 (Swan Geese Pass Through), Xuanniao gui 玄鳥歸 (Swallows Go Back), Qunniao yangxiu 群鳥養羞 (Flocks of Birds Stockpile Morsels).

Even though we are in Autumn (a Yin time of year) it is clear that Yin and Yang are engaged in a closely intertwined dance. During White Dew, the days can still be quite warm and somewhat humid – today here in New Jersey is in the 80s, and the humidity of last week’s hurricane is palpable. However, evenings are starting to dip in temperature. Therefore, one of the traditional prohibitions this time of year is wearing clothes that are too light or too exposing of the body. During the early morning hours or in the evening be sure to wear clothing that affords protection against the gradually cooling temperatures (last weekend I wore a light fleece going over to our early Saturday morning Qigong class). In some places the weather continues to be fairly warm and thus slightly out of sync with this Seasonal Node. In those places guard against rapid temperature fluctuations as they may trigger colds or other upper respiratory problems.

Another caution this time of year is overconsumption of cold foods. Eating cold foods burdens the Spleen and Stomach, and this is more so during the Yin and colder times of the year when the body is trying to consolidate its Yang warmth. Thus in Chinese it is said, “bai lu shen bu lu, zhao liang yi xie du (白露身不露，著涼易瀉肚) – during White Dew be sure not to overexpose the body as cold can easily lead to diarrhea.

The conceptual idea to start focusing on during White Dew is Nourishing the Yin (養陰). Now, this doesn’t mean that we should all go out and start taking Yin nourishing herbs such as Di Huang! To understand this, we need to think deeply about the real meaning of Yin and Yang beyond basic correspondences. The Su Wen tells us that the sage nourishes Yang in the Spring and Summer and nourishes Yin in the Autumn and Winter (所以聖人春夏養陽，秋冬養陰). Here, Yin means the movement of contraction/harvest (收) going towards storage (藏). These are the very defining concepts of the Autumn and Winter seasons. This time of year we should all start slowing down, going to bed just a little earlier, and taking stock of our lives (i.e., literally moving our minds inward in self-reflection).

In more concrete medical terms, some of the most common problems our patients will see this time of year are seasonal allergies and rhinitis. Here in New Jersey I’ve seen a significant rise in allergy complaints in the last few weeks. Patients can be taught simple home remedies such as using a Neti pot to keep sinus passages clear and open. Alternately, they can do a steam inhalation with eucalyptus oil. Since Autumn is the season of dryness, if patients suffer from very dry nasal passageways, they can rub a small amount of coconut oil inside their nose on a daily basis. I predict one of the challenges clinicians will see in the next few months is the confusing of common cold symptoms with COVID infection symptoms. Since many overlap, we will all need to continue to be vigilant in whatever infection control measures we are taking professionally and personally. I strongly suggest, even in places where it is not mandatory, that people continue to wear masks in stores, clinics, etc… I am also suggesting all my patients get vaccinated. There is a long history of the use of this sort of preventive treatment in China, and thus the use of vaccinations is very much in accord with the medicine we practice.

When choosing treatment points this seasonal node we can focus on those that have a Lung association. In Tung’s acupuncture, some useful points include Mu (木穴; 11.17), and the Dao Ma combination of Chong Zi (重子穴; 22.01) and Chong Xian (重仙穴; 22.02). In both September and October, Mu is one of my most frequently used points. It has the association of Lung Channel in Tung’s Five Phase system, and it lies on the palmar surface of the index finger (thus placing it on the Hand Yangming – also a Metal channel). It treats a wide range of conditions of the upper burner related to Wind patterns such as the common cold, seasonal allergies, and sinus congestion. Patients can also be taught to massage these points as needed. For a more detailed discussion of these points please refer to the Practical Atlas of Tung’s Acupuncture (click here to find out where it can be purchased).

Aside from Tung’s acupuncture, this is the time of year to start doing preventive moxibustion on Zu San Lu (ST-36), or other treatment of the Stomach channel. Chinese medicine has a variety of ways to match time and channels or organs. According to the Zun Sheng Ba Jian, the second month of Autumn corresponds to the Stomach channel, which is why the seasonal node exercise for White Dew is associated with it, and treats lips turned dark in color, swelling in the neck, retching, mental disorders, and flushing of the face (all Stomach channel symptoms). Finally, since Soil-Earth is the mother of Metal, treatment or supplementation of the Stomach channel has a beneficial and supplementing effect on the Lung.

Diet for White Dew

During White Dew the foods we eat should gently moisten dryness and protect the Lungs. While the days are still hot we can eat mildly hear clearing foods but again being cautious about eating very cold (or chilled) foods. In order to help build Yin in the body we also can increase mildly sour foods. White Dew is still a season of fresh fruits that fit these guidelines perfectly, such as peaches (although we are really at the tail end of peach season in New Jersey), apples and pears. Other foods to eat include watery vegetables such as zucchini. For those near Asian groceries, White Dew is the time to eat nagaimo (shan yao 山藥 in Chinese) and fresh lily bulbs (百合).

Rice congees are a perfect fit for White Dew in that they are gently moistening and, taken warm, supportive of the Spleen and Stomach. One of the traditional White Dew congees is Lily Bulb and Pear Congee. To make this take one large Asian pear and slice into bite sized pieces (the peel can be left on). Then take one fresh edible lily bulb and separate out the corms. Cook the pear and lily bulb in a medium sized pot of water and rice (with a rice to water ratio of about 1 to 6). Simmer until the rice starts falling apart and the mixture becomes like watery oatmeal. Finish by adding a small amount of local honey to taste.

To read more about general health tips for Autumn please click here.

End of Heat 處暑 Seasonal Node

Earlier this week on Monday August 23rd we entered the current seasonal node - Chu Shu 處暑, ‘End of Heat’.  I’ve been putting off posting this for a few days because, well, the heat has certainly not ended where I am! Today the actual temperature with humidity will make it feel close to 100 degrees (38 degrees Celsius). This is a good reminder to us that the model of the seasonal nodes is not one that always describes actual local weather conditions. Rather, it teaches us about the overall ebb and flow of weather patterns and how they can affect health. It also may need to be reevaluated sometime based on the unfortunately fact we are now dealing with manmade climate change. Just a few weeks ago at the summit of Greenland, some 2 miles in elevation, rain fell instead of snow for the first time in recorded history.

All that said, while we can continue to expect warm weather for the near future, there is a cooling trend that is starting in a real way. In the next 2 weeks the local predictions here are that there will be a break in the current more oppressive heat. The days are also noticeably shorter. While the ‘End of Heat’ is not a great description for today, it is a good description for the general pattern we are starting to experience in the Northern Hemisphere.

End of Heat is the second seasonal node in Autumn, and Autumn is the time of year when Yin grows. All things are gradually moving towards the hibernation phase and many plants are being readied for harvest. This is why in the Neijing, the movement of Autumn is described as 收 – receiving, taking in, putting away, gathering in. The names of the smaller 5-day periods of this seasonal node are quite interesting and illustrative of this idea. The first is called Ying Nai Ji Niao 鷹乃祭鳥, Hawks Start to Sacrifice Birds. This time of year starts the slow march towards the death phase of nature, and many plants and animals with short life spans won’t make it to next Spring. The image of hawks harvesting or killing smaller birds then fits perfectly with this image. The next two 5-day time periods are Tian Di Shi Su 天地始肅, Heaven and Earth Become Austere, and He Nai Deng 禾乃登, Rice Plants Are Harvested and Presented as Offering. Just as this is the time of year for bringing things to harvest, it is also the time for us to start becoming quieter and more introspective, for us to take stock of what, out of the myriad things in our lives, is really important (i.e., we become austere like heaven and earth). In Japan, instead of Hawks Start to Sacrifice Birds, the first segment is called Wata no Hana Shibe Hiraku 綿柎開 – Cotton Flowers Bloom.

In more tangible respects there are things to keep in mind to maintain health this time of year. The first traditional recommendation for Chu Shu is Ben Franklin’s favorite – ‘early to bed, early to rise’ (zao shui zao qi 早睡早起). When Yin predominates in nature we can mimic that in our own body by getting more sleep. In the summer it is permissible to stay up later and still wake up early because in the Yang time of year less sleep is just fine. However, now that Autumn (a Yin season) is upon us, we need to get a little more rest. My general recommendation to patients is to get into bed a bit earlier, preferably before 11pm or midnight. Here’s a little quiz for other Chinese medicine providers – why is it important to get to bed before this hour? (Hint – it is not because of the Liver hour just afterwards)

Even though this week is still humid, the weather pattern associated with Autumn will eventually be dryness. Thus, another caution during Autumn is not becoming too dry. One way we do this is through diet; now is the time to start focusing on shao xin, zeng suan 少辛增酸 – ‘less spicy, more sour’. Spicy flavors are mildly drying. Spicy also promotes sweating which can dry the body. To the contrary, sour foods are gently moistening and hold in sweat. Increasing the amount of foods such as vinegar, pickled vegetables, and fruits such as plums is appropriate to Autumn. Other moistening foods include milk, soymilk, and fruit juices (especially apple or pear). This recommendation should be taken less seriously for those with very damp constitutions or presentations, and can also be moderated when the outside weather continues to be damp.

One traditional recipe for this season is Pear and White Wood Ear Soup. This dish is just simply delicious, and it is effective for supplementing the Lungs, nourishing fluids, and moistening dryness (without being so cloying as to create dampness).

Pear and White Wood Ear Soup 雪梨銀耳湯 

Ingredients:

•  1 large Asian pear 雪梨

• 2 dried white wood ear mushrooms 銀耳

• 1 small fresh edible lily bulb 百合

• About ½ cup white or rock sugar

 Directions:

1. Soak wood ear for about 30 minutes, until softened

2. Rip wood ears into bite sized pieces, peel and cut pear into medium bite sized chunks, and separate out lily bulb into individual corms

3. In a pot, put about 6 cups of water together with all ingredients; bring to boil and simmer for 30minutes to 2 hours on a very low heat 

For those who like wood ears crisper, go for the shorter simmer time. For those who like things softer and more gelatinous, cook longer. My suggestion is to take small tastes along the way. This soup can be served warm or chilled (depending on preference and outside temperature). 

The last recommendation I’ll offer is for those patients who continue to experience symptoms of damp, heat, or the combination thereof in the form of summerheat. A traditional channel based recommendation for End of Heat is regular acupressure on Cheng Shan BL-57. This point helps expel damp and clear heat, and treats many symptoms of lingering summerheat such as headache, body aches, heavy limbs, or diarrhea. Notice that this area of the leg is one of thick flesh, and remember that the seventh chapter of the Ling Shu describes a needling method based on the five tissues and their relationships to the five viscera. One of the passages from that chapter reads:

四曰合谷刺，合谷刺者，左右雞足，針於分肉之間，以取肌痺，此脾之應也

The fourth is called united valleys piercing. United valleys piercing is to pierce left then right from the same hole, like a chicken's foot. Pierce to the division between the flesh. This treats flesh block (bi). It is in resonance with the Spleen.

Here we see that needling into fleshy areas of the body treats problems of the flesh as well as treats problems of the Spleen. As dampness is the disease evil of the Soil/Earth phase (and thus the Spleen), this needling technique also has resonance with its treatment. For example, over the last few weeks, patients in my office have been complaining of aching and heaviness in the joints, especially of the knees, hips and in general lower extremities. This is because dampness, as a Yin disease evil, commonly moves down in the body. One of the points I’ve been using over and over again to work with this is Jian Zhong 44.06. The point, located on the shoulder, is in a fleshy area of the body just like Cheng Shan BL-57 is. Likewise, it treats damp accumulation of the joints and extremities. Other points in the shoulder area, such as Bei Mian 44.07, are specifically indicated for digestive problems such as abdominal distension, vomiting or enteritis. This is because, like Jian Zhong 44.06 and Cheng Shan BL-57, Bei Mian is in an area of thick flesh and thus treats problems of the Spleen. This time of year as we are still experiencing summerheat and dampness, these types of points can be frequently used.

Stay hydrated, stay cool, but prepare for the cooler weather to come.

Beginning of Autumn 立秋 Seasonal Node & Ghost Month!

It’s hard to believe I’m writing this, but today, Saturday August 7th, is the beginning of Autumn in the traditional calendar. Although in the modern western world August is a summer month, the Chinese calendar is concerned with the relative balance of Yin and Yang in the natural environment over temperature as a marker of the seasons; this is closely tied to day length. Summer Solstice in June was the longest day of the year. By now the days are getting gradually shorter, and we are only 6 weeks away from the Autumnal Equinox, a day of balanced light and dark. Therefore even though August weather can still be hot we are in the time of growing Yin and contraction in the natural environment.

As a symbol of the growing Yin time of the year, the seventh lunar month (i.e., August), is Ghost month in Chinese lore (ghosts being Yin entities). This year the seventh lunar month starts tomorrow on Sunday August 8th, the day this blog goes out as an email. In the traditional Daoist calendar this is the day that Yama, the King of Hell, opens the gates of hell to allow all the spirits of the deceased to wander the earth – basically a one-month vacation for ghosts. This happens until the gates are once again closed at the end of the lunar month. The culmination of the month is the 15th lunar day (this year August 22nd), which is known as Zhong Yuan Jie (中元節).

Throughout this month there are many taboos that Chinese culture observes. These include not allowing the elderly, the very young or generally physically weak people to do various activities outside at night. This is the time of day when ghosts are most active! Qigong should also not be practiced outside late at night during this time. Whether or not we believe that this month is the time of ghosts, what this custom perhaps does is serve as a reminder of how the natural balance of Yin and Yang is shifting in a very real way this time of year. 

Now back to the Seasonal Node… While the weather is beginning to shift to Yin, August can still be damp and humid. It is also the time of tropical storms which bring moisture and wind. In Chinese medicine, weakness in the Spleen and Stomach leads to damp accumulation. In early Autumn we therefore should avoid dampness and simultaneously strengthen the digestive organs. One way to accomplish this is to eat light and clear foods, increase the amount of seasonal vegetables, and eat a little less meat. Vegetables can be consumed lightly steamed or stir-fried, or in the case of light salad greens, raw. In general avoid overly hot, spicy foods. Congees are appropriate to help strengthen the digestive organs and one traditional congee recipe for this seasonal node is Euryale Seed and Discorea Congee (Qian Shi Shan Yao Zhou 芡實山藥粥).

Euryale Seed and Discorea Congee (Qian Shi Shan Yao Zhou) 芡實山藥粥

Ingredients:

• 1 cup rice (use glutinous rice if available)

• 200g Euryale seed (Qian Shi )

• 200g Discorea (Shan Yao )

• 200 g sugar

Directions: 

1. Grind rice, Euryale seed, and Discorea to a powder. Mix the three together with sugar and blend well so evenly mixed

2. In a pan, add 50 – 100g of blended powder to cold water, enough to make a thick soupy consistency

3. Put over medium flame and warm for several minutes, stirring occasionally

4. Enjoy in the morning on an empty stomach (consume warm)

This congee strengthens the Spleen, stops diarrhea. However it is contraindicated for patients with diarrhea due to infections, or with damp heat type diarrhea.

Euryale ferox

In addition to dietary recommendations we can perform acupressure on supplementing points such as Zu San Li (ST-36). If patients tend to cold and vacuous patterns of the Spleen and Stomach, gentle direct thread moxa at Zu San Li is also applicable. Those familiar with Tung’s acupuncture can needle the Zu San Tong (足三通) Dao Ma group, consisting of Tong Guan 88.01, Tong Shan 88.02 and Tong Tian 88.03. These points are the main Dao Ma group for Heart, but really they function like Pericardium channel points, which is why they are indicated for Spleen and Stomach problems. Furthermore, in terms of Five Phase theory, supplementing Heart will strengthen Spleen because of the engendering cycle relationship between Fire and Soil-Earth.

Autumn is the season associated with the Lungs, and thus even though we should avoid very spicy foods, mildly acrid foods are good this time of year for Lung function. These foods include ginger, scallion, leek, and black pepper. Mildly sweet and slightly sour fruits also help moisten and benefit the Lungs, including the now in-season stone fruits (i.e., plums and peaches). This recommendation however should be based on individual patient characteristics. For example, if patients have Spleen vacuity with dampness they should avoid overly sour foods. 

As August continues, we need to be cautious of sudden returns of very hot and humid weather, a common weather pattern here in New Jersey. In Chinese this is called “The Old Tiger of Autumn” (Qiu Lao Hu 秋老虎). When the old tiger rears its head again Summerheat pathogens are a risk – symptoms of this include headache, dizziness, nausea or vomiting, poor appetite, stuffy chest, heavy or fatigued limbs, and possibly diarrhea. If intense hot and damp weather returns, focus the diet on foods that are cooling and moistening. Foods to consider adding on a daily basis include all sorts of sprouts (e.g., mung bean or alfalfa), cucumbers, muskmelon, winter melon, tomato, and loofah. Mung beans are very cooling, and in hot weather they can be made into a sweet dessert soup. For more serious conditions consider giving patients formulas such as Huo Xiang Zheng Qi San.

Here’s a formula from the Zun Sheng Ba Jian (遵生八箋) – the Eight Treatises on Following the Principles of Life. Written by a scholar by the name of Gao Lian at the end of the Ming Dynasty (1368-1644), the text is an almost encyclopedic collection of all manner of Nourishing Life (養生) recipes, techniques, theories, etc… One of the formulas specifically for Autumn is called Conserve the Spleen Pill (攝脾丸). It treats damage to the Spleen that happens during the Autumn months that leads to abdominal distension and diarrhea. The ingredients listed are Mu Xiang, He Zi, Hou Po (ginger fried), Wu Bei Zi (slightly toasted), and Bai Zhu (earth fried). These ingredients would be ground to a powder and made into pills the size of a Tung Tree seed, and 10 pills would be a daily dose. 

I hope everyone is having a great end of Summer and start of Autumn, and is continuing to wear masks and be safe!

Great Heat 大暑 Seasonal Node

We are in the hottest time of the year according to the traditional Chinese calendar – the San Fu 三伏 period. Recently here in the US Northeast, we are having very hot and very humid weather, although this week has been slightly better. Appropriately, yesterday Thursday July 22, was the beginning of the last node of Summer in the Chinese calendar – Great Heat (Da Shu 大暑).

In some parts of the world this part of the summer can also be one of the dampest times of year.  As we’ve discussed before, each of the 24 seasonal nodes (jie qi 節氣) can be further broken down into 3 five-day periods of time, known as the 72 Material Manifestations (wu hou 物候). The 3 periods within Great Heat are Decaying Grass Transforms into Fireflies (fucao hua wei ying 腐草化為螢), Earth Lies Wet Beneath Sweltering Heat (tu run ru shu 土潤溽暑), and Heavy Rains Fall Intermittently (da yu shi ying 大雨時行). The Japanese versions of the first of these is Paulownia Trees Produce Seeds (kiri hajimete hana o musubu 桐始結花). In these rather poetic names we see the images of plant life coming to an end of growth (in particular, delicate plants such as grasses), and we also see references to the combination of both dampness and heat in nature.

The health maintenance guidelines for Great Heat are to focus on clearing heat, boosting qi, and treating winter diseases ahead of time (冬病夏治).  Clearing heat seems to be intuitive – too much heat in the body needs to be removed to keep us in balance. But why should we also boost the qi? The Yin Yang Ying Xiang Da Lun (Su Wen Chapter 5) says, “the qi of strong fire weakens” (壯火之氣衰), “strong fire feeds on qi” (壯火食氣), and “a strong fire disperses qi” (壯火散氣). The reason we need to boost qi this time of year is because too much heat in the environment drains and weakens the qi internally. Likewise, excessive sweating damages both the qi and the fluids. One potential general maintenance herbal formula this time of year is Sheng Mai San, the combination of Ren Shen, Mai Men Dong and Wu Wei Zi. When giving this formula during Great Heat, my suggestion to use either plain Chinese white ginseng, or American ginseng, as Korean red ginseng will be too hot. Sheng Mai San in small doses builds qi, clears heat, and nourishes the fluids with herbs that are not so cloying that they would worsen internal dampness.

As already mentioned, now is the San Fu period. This time of year there is a tradition of applying mustard plasters to acupuncture points on the back, a practice known as San Fu moxibustion. While called a type of moxibustion, the heat source for this treatment is not burning mugwort, but the heat derived from the mustard (and other herbs) plasters that are placed on the skin (click here to read more about San Fu moxa).

In addition to San Fu moxa , this time of year we can start applying regular moxibustion as well The Bian Que Heart Classic (扁鵲心書) suggests that every year at the transition between summer and fall we should apply moxa to Guan Yuan REN-4. As part of the recommendation the text suggests the application of 300 cones every 3 years for people over the age of 30, every 2 years for people over the age of 50, and yearly once age 60 is reached.  While 300 seems like a lot of cones, we don’t have to do them all in one sitting. Break up application of moxa into smaller amounts of cones and proceed daily for several weeks; in other words we are looking for a total of 300 over time, not 300 all at once. Other points to consider for moxibustion include Zu San Li ST-36, Shen Que REN-8 and Qi Hai REN-6.

The caution for Great Heat is to be on guard against damp-heat and its ability to damage the Spleen-Stomach and hamper appetite and digestion.  One way to do this is through diet, which we discuss below. Another traditional recommendation to accomplish this during the current seasonal node is herbal foot bathing.  One effective Great Heat foot bath recipe includes Pu Gong Ying 30g, Su Mu 30g, Gou Teng 25g, Fu Ling 25g, Bai Fan 15g, Fang Feng 15g, Han Fang Ji 15g.  Boil these herbs in about ½ gallon of water for 20-30 minutes. Then, cool until able to be used as a warm soak, and soak feet for about 30-40 minutes. These herbs are also effective for treating athlete’s foot, a common problem of this time of year, and a very obvious manifestation of excess damp-heat. For this condition use the same soak frequently, at least twice daily, with 3 days (of twice daily) being one course of treatment.

For practitioners of Tung’s (Dong’s) acupuncture, we can apply these same principles in general maintenance or preventive treatments. In point prescriptions consider adding points that have a general qi supplementing function such as Ling Gu 22.05 and Si Hua Shang 77.08. We also can choose points that generally clear heat such as Zhong Kui or the Wu Ling and Shuang Feng points along the back. In my bloodletting book I also detail another Taiwanese method of treating excessive summerheat by bleeding. Click here for more information on the book. For patients who tend towards being deficient, after bloodletting in the clinic, administer one dose of Liu Wei Di Huang Wan in tablet form (this was Master Tung’s practice in his own practice).

Diet for Great Heat

Along with the guidelines described above, during Great Heat we should simultaneously clear heat and drain damp, while boosting the qi and protecting the Spleen and Stomach. Avoid overly spicy foods and foods which are overly heating. This is the time of year to eat in-season vegetables, especially those that clear heat and nourish fluids such as cucumber, raw tomato, and bitter melon. Gentle heat clearing herbs can be added to the diet such as mint and Huo Xiang (agastache), and this is the seasonal node when Huo Xiang congee is traditionally consumed.  In China people drink winter melon juice during Great Heat. I honestly don’t find this too appealing so I suggest in the west we substitute winter melon juice with watermelon juice!

One fun recipe for Great Heat is stir fried lotus root…

Stir Fried Lotus Root

Ingredients:

• 1 lotus root (about ½ lb)

• 1” piece of ginger, chopped

• 1 cup roughly chopped scallion

• 2 cloves garlic, peeled and chopped

• 1 tablespoon sesame seeds

• white vinegar

• cooking oil (sesame)

• soy sauce or tamari

 Instructions:

1. Peel lotus root and cut into slices about ¼ inch thick, submerge in water with a small amount of white vinegar to prevent discoloration

2. Heat some cooking oil in a large frying pan, add ginger and garlic and cook until fragrant

3. Drain lotus root and place the slices in pan in a single layer; cook until they start to change color and become slightly translucent and then turn over and cook a few minutes longer

4. Add in sesame seeds, a splash of soy sauce or tamari, and the scallions and fry a short while longer until the scallions start to wilt

5. Remove from heat and enjoy

This recipe stops thirst, expels heat, and clears heat to engender fluids. Furthermore, it also supplements the center and nourishes the shen-spirit.

I hope everyone is staying cool and dry!

Minor Heat 小暑 Seasonal Node

This past weekend was the Independence Day holiday in the United States. The weather was just perfect for Summer, although earlier last week the weather was very, very hot, and quite humid. Even indoors in air conditioning there was an oppressive feeling. Yesterday was similarly hot, and the evening culminated with lighting storms. The heat of Summer has definitely arrived and it is right on time, as today July 7th, starts the next seasonal node of 2021 - Minor Heat (Xiao Shu 小暑).

The Minor Heat seasonal node marks an important change in the movement of Qi in the natural world. Summer Solstice (Xia Zhi 夏至) began the transition from Yang-expansion to Yin-contraction in the environment. Therefore, Minor Heat is the first seasonal node in the nascent Yin time of the year. However, although we are transitioning into the Yin time of the year, it is still hot and getting hotter. Weather change happens slowly. Think of it like a train barreling ahead at high speed. Once the conductor decides to stop the train and put it in reverse, she first puts on the breaks. Even though the breaks are applied, it takes several hundred feet before the train actually stops. Only then will it very slowly start moving in reverse. The movement of the seasons is just like this. Once we have flipped the switch from Yang to Yin, the weather still continues to warm for some time before the very slow movement in the opposite direction begins. 

The smaller segments of the seasons for this Node are Warm Winds Arrive (温風至), First Lotuses Blossom (蓮始開), and Hawks Learn to Fly (鷹乃学習).  These three are the traditional Japanese version of the mini-seasons. The Chinese version is slightly different, with the second being called Crickets Take Up Residence in Walls (蟋蟀居壁).  Personally, I’d rather have lotuses than crickets invading my house!

The most important “to do” recommendation during this time is to nourish the Heart by maintaining an optimistic outlook. Why is this? June and July are the months associated with the Fire phase. Also, if we overlay the 12 time periods of the day with the 12 months of the year (i.e., the 12 two-hour periods of the day that each correspond to one of the primary channels), June is the time of the Heart channel and July the Small Intestine channel. Both are Fire phase. Since this is the Fire Phase time of year, it is the time of the Heart Zang. We nourish the Heart by keeping a calm mind and being optimistic. Pessimism or other negative emotional states can lead to patterns such as Liver stagnation, which in turn can transform into heat and harass the Heart. We can also nourish the Heart and regulate the Fire phases by doing some specific Qigong exercises. Over the last few weeks in our online Qigong classes we have been doing exercises for the Fire channels in the body. While these exercises are not yet posted, you can see other basic Qigong exercises on my Youtube channel by clicking here.

As mentioned above, the first 5-day period of Minor Heat is known as Wen Feng Zhi (溫風至), - Warm Winds Arrive. This certainly describes what is happening in the weather right now, especially in the Northeastern United States! The weather has been hot, and very humid. Therefore, we need to be careful about environmental dampness damaging the body. As clinicians we should instruct patients who are prone to damp patterns on how to eat, dress, etc… In this light the main “to avoid” this time period is undue exposure to cold and excessive consumption of cold items (both cold temperature and cold thermal nature). While it may seem logical to be in cold places in cold weather, there is certainly a problem in the west with using air conditioners to cool rooms to temperatures lower than we’d feel comfortable with in winter! Furthermore, the overconsumption of cold (and especially cold and sweet) food and drink damages the Spleen leading to more damp accumulation. Instead, we should drink beverages that are cooling, as well as either bitter (to drain), or acrid (to move). This will cool the body without developing damp stagnation. Examples include green teas, or chrysanthemum and mint herbal teas. In China summer is the season to drink green teas such as the famous Dragon Well – Long Jing Cha 龍井茶.

Diet for Minor Heat

As we mentioned above, during Minor Heat there is significant dampness and heat in the environment. Therefore, we should consume foods that are cooling and either bitter or acrid. For example, this is the time of year to consume in-season fresh greens. In addition to chrysanthemum and mint we can also consume lotus leaf tea; lotus is a plant with a summerheat cooling nature that is also slightly bitter to drain heat and dampness. Advise patients to sip fluids throughout the day so they don’t dehydrate rather than drinking copious amounts of iced beverages all at once that may exacerbate damp conditions. If patients have damaged fluids, they can consume cooling and moist vegetables (such as cucumber) or fruits (such as watermelon).

One traditional recipe for this time of year is congee made from Yi Yi Ren (pearl barley) and adzuki beans. This basic combination is mild and neutral in temperature, and both the Yi Yi Ren and adzuki beans drain dampness. Yi Yi Ren strengthens the Spleen and adzuki beans clear heat as well.

Preparing for the Seasons to Come – A Medicated Liquor

One of the maxims in Chinese medicine is that it is usually best to treat disease before it arises, and part of that is being well prepared ahead of time. The second chapter of the Su Wen says, “Thus, the Sages did not treat disease that were already manifest, they treated disease that had yet to arise. They did not treat what was already in a state of disorder, they treated before disorder arose” (是故聖人不治已病，治未病，不治已亂，治未亂). It goes on to explain that doing this was akin to digging a well after one is thirsty, or forging weapons after war has already broken out. Both are too late to do as much good as possible.

In this spirit we can use this time of year to start preparing formulas to use in a few months, once the weather becomes cold again. A very traditional format of herbal formulas that is particularly suited to the colder weather is medicated wines (also called medicated liquors since they are made with distilled spirits, not actual wines). Ethyl alcohol is warm, acrid and sweet. This combination means that it can warm and course the Qi and Blood, as well as supplement at the same time. When herbal formulas are prepared in alcohol (i.e., ethanol) the functions of the ingredients are amplified in this therapeutic direction.

One very useful formula that we can start preparing now for use in colder weather is Song Ling Tai Ping Chun Jiu (松齡太平春酒), a formula I will simply translate into English as Great Harmony Eternal Spring Wine. Here are the ingredients…

Great Harmony Eternal Spring Wine

Ingredients:

• Shu Di Huang 250g

• Dang Gui 125g

• Hong Hua 15g

• Gou Qi Zi 125g

• Fo Shou 15g

• Gui Yan Rou (i.e., Long Yan Rou) 250g

• Song Ren (pine nuts) 125g

• Fu Shen 50g

• Chen Pi 25g

Directions:

• Choose as best quality possible for each of the above medicinals. Place in a clean wide-mouthed jar with about 2.5 liters of vodka, or another distilled spirit of similar alcohol content. Allow the medicinals to soak for at least a month (although up to three months is preferable). Periodically the mixture be stirred with a clean spoon, or simply shaken a little to agitate the liquid. Once ready, take one or two shots per day as a dosage (spread out if two).

This formula was a favorite of the Emperor Qianlong (1711 – 1799; r. 1735 – 1796), one of China’s most important Emperors and one of the longest reigning monarchs in world history. The formula, crafted by Imperial physicians, was one of the Emperor’s longevity tonics. While we find a few variations on the formula today, in general the major ingredients and thus therapeutic thrust of the formula is the same. Overall the formula strengthens the Spleen, benefits the Qi, and nourishes and quickens the Blood. It is contraindicated for patients with significant internal heat patterns, and for those who normally cannot consume alcohol.

The very interesting name of the formula is deserving of a short discussion. The first word Song (松) means a pine tree, and the second word Ling (齡) means years of age. At first glance this is an odd combination of words – age of a pine tree. Put together it is a reference though to long life. The pine, as an evergreen, is a symbol of enduring life and youth, which is why pine nuts are seen as a longevity food. These two words are also reminiscent of the Chinese phrase Song He Yan Ling (松鶴延齡) – “live as long as the pines and cranes.” Both of these are powerful symbols of longevity in Chinese culture. Finally, going back even to the works of Confucius, in the Analects there is a passage that says, “The Master said, "When the year becomes cold, then we know how the pine and the cypress are the last to lose their leaves” (子曰：歲寒，然後知松柏之後彫也). Thus, in old age (when the year becomes cold) it will be apparent who maintains youthful vigor. We know from history that Emperor Qianlong certainly did!

I hope everyone is staying cool and dry, and that we are all thinking of how we can start preparing for the colder months a little ways off in the future.

Summer Solstice 夏至 Seasonal Node

Happy Fathers’ Day to everyone out there! I’ve been behind in blogging about the seasonal changes, but thought this weekend was a good time to get back on it. This is an essential time in the change of the seasons as we will discuss shortly. In the United States we are also at a time when we seem to be slowly recovering from the global pandemic. To be sure, there is still work to do and there are parts of the world where more progress is needed. But here, with the success of public health measures and the wider adoption of vaccination, things are looking up. In my classes on the history of ideas and medicine in China we’ve been discussing this in relation to the historical use of pre-vaccination technologies in China, such as variolation. For those who are interested in learning more about this medical technology in China click here for an excellent academic article on the topic.

This weekend also marks the very first time that Juneteenth is a federal holiday in the Unites States! And, in the United States, June is also Pride Month. My hope is that over time our societies continue to become more accepting of all the people and voices that comprise them.

But, let’s get back to the seasons… Later tonight at exactly 11:32pm Eastern Daylight Time, the Northern Hemisphere will reach the astronomical Summer Solstice. At that moment the North Pole will be at its maximum tilt (about 23.5 degrees) toward the Sun, resulting in the longest day and shortest night of the year. This means that tomorrow the days will slowly start getting shorter, heralding the cosmic transformation from Yang to Yin that has just been triggered.  

In addition to being one very important moment in time, the Summer Solstice (Xia Zhi 夏至) is also the name of the seasonal node that starts tomorrow, Monday June 21st. This node marks the apex of Yang in the natural world as well as the rebirth of Yin that will eventually culminate with the longest night on the Winter Solstice in December. In relationship to the times of day, Summer Solstice corresponds to high noon, the Wu (午) hour, and is the time of the Heart channel. When we break down Summer Solstice into the smaller five-day periods of time, it includes the time periods know as Deer Shed Antlers (Lu Jiao Jie 鹿角解), Cicadas Begin Singing (Tiao Shi Ming 蜩始鳴), and Pinellia Grows (Ban Xia Sheng 半夏生). Notice that this time is when Ban Xia is growing, the king of drying damp and getting rid of phlegm turbidity (a Yang herb to treat a Yin pathology). Likewise, in China this is the time of year to harvest Aconite (Fu Zi 附子) to enhance its Yang nature. Interestingly, in Japan there are different names for the 72 Material Manifestations (七十二物候). The names of these three mini seasons for the Japanese are Prunella Dries (乃東枯), Irises Bloom (菖蒲華), and Pinellia Grows (半夏生 - this one is the same as the Chinese calendar).

In Yijing (I Ching) symbolism, this time period is represented by hexagram 44, made up of Qian-Heaven trigram (3 solid yang lines) over Xun-Wind trigram (1 broken yin line under 2 solid yang lines). Thus, the complete hexagram is 5 solid Yang lines over one broken Yin line at the bottom – Yin is being birthed once again. One of the translations for the name of Hexagram 44 is “The Queen,” also showing that this time of year begins the transition towards returning inward to the hidden, the Yin, the Blood, and the Dark Mother that is referred to in the first chapter of the Dao De Jing.

Practically speaking, although this is a time of transition to Yin, this is still a hot and damp season. This coming week in New Jersey promises to be hot and wet. The first health recommendation for Summer Solstice is to focus on clearing summerheat and draining dampness. For example, various skin problems due to external contraction of summerheat damp are commonly seen now. It is also common to see other symptoms of summerheat strike such as malaise, fatigue, low-grade fever or heat effusion, low-grade headache, nausea, etc… There are several ways we can help ourselves as well as our patients when they present with summerheat damp symptoms. First, is to regulate diet, which we will discuss more below. We can also counsel basic lifestyle recommendations, such as dressing appropriately to the weather (such as wearing light clothes made of natural materials that breathe well), staying in shade in the midday when temperatures are highest, and drinking plenty of light and clear fluids. This is especially important for our older patients, since as we age we lose the normal ability to adapt to more extremes in temperature. Furthermore, seniors are more likely to be on prescription medications or may have chronic medical problems that inhibit perspiration or make extremes of temperature less tolerable. Some medications also increase sensitivity to sun raising risk of sunburns (examples include tetracyclines, quinolones such as Cipro, Celebrex, and some chemotherapeutic agents).

In terms of therapy, Dr. Zhong Yong Xiang of Taiwan suggests bleeding the jing well points on all the fingers for more severe cases of summerheat strike. This bloodletting method is described in my book Pricking the Vessels. We can also consider performing Gua Sha on the back to help move stagnant summerheat damp in the exterior muscle layer.

The next recommended “to do” during Summer Solstice is Shui Hao Zi Wu Jiao 睡好子午交. This means sleep well during both the Zi and Wu hours. Certainly, sleeping well is something we should be doing all year long. Zi and Wu refer to the time periods of midday and midnight, with Zi being the 11pm – 1am hour, and Wu being the 11am – 1pm hour (to be adjusted for standard time in locations that observe daylight savings time). In general it is important to get into bed before the Zi hour. Remember, the Zi hour is the time of transition from Yin to Yang, representative of the Winter Solstice. After this time period our bodies are already in a state of Yang expansion, the movement contrary to good sleep. Getting to bed and sleeping through this hour ensures that we really rest, that we really go into the state of storage that replenishes our vital substances.

The Wu hour is also a time of transition, and like the Summer Solstice, represents the change from Yang to Yin. The traditional recommendation is to take a short nap during this time to harmonize the body with this movement of Yang to Yin. That said, the recommendation is just a short nap of maybe only 30 minutes time (this is just the beginning of Yin after all). After that, don’t linger. Get up and back to normal activity.

Diet for Summer Solstice

As already mentioned, Summer Solstice is the time of transition from Yang to Yin in the natural world. That said, Summer Solstice is still a time of damp and heat in many places. Therefore, the basic strategy of clearing heat and draining dampness can help guide us in our diet strategy. It is important to keep in mind that during summer over-sweating and prolonged exposure to heat can deplete the Qi and fluids of the body. So, once we are clear of heat and damp, if there is vacuity we can focus on supplementation. However, since this is a hot time of year, cool supplementation is best. 

In summary we can generalize this is the time to eat foods that clear heat (especially summerheat), drain dampness, nourish the Qi and boost fluids. Examples include cucumber, winter melon, luffa, tomato, honeydew melon, star fruit, peach, plumb, and mung beans. This is also a good time to eat bitter melon (ku gua 苦瓜). When I lived in Okinawa as a graduate student, bitter melon was a basic staple of food since Okinawa is a very hot and damp climate.  

Here’s a formula from the Zun Sheng Ba Jian (遵生八箋) – the Eight Treatises on Following the Principles of Life. Written by a scholar by the name of Gao Lian at the end of the Ming Dynasty (1368-1644), the text is an almost encyclopedic collection of all manner of Nourishing Life (養生) recipes, techniques, theories, etc… This is a seasonal formula for summer from this text.

 Cardamom Powder 豆蔻散

Ingredients:

• Cao Dou Kou 草豆蔻 120g (toast until yellow together with 120g of fresh ginger, then remove the peel for use)

• Mai Ya 麥芽 300g (dry fry until yellow)

• Shen Qu 神曲 120g (dry fry until yellow)

• Zhi Gan Cao 炙甘草 120g

• Pao Jiang 炮薑 30g

Grind all ingredients to a fine powder. Take a small amount daily with water or tea. During summer as heat and dampness increases, occasionally this will negatively affect people’s digestive function and appetite. This formula opens the Stomach, increases appetite, treats abdominal distention and is particularly useful if weather is cooler or damper than usual.

I hope everyone is staying cool and dry. For those who would like to read more about Summer seasonal recommendations in general, please click here.

I also have a more comprehensive course on acupuncture and the seasons, including how to use diet, acupuncture (even Tung’s acupuncture) and other lifestyle recommendations to harmonize with all the seasonal nodes. For more information on that class, click here. 

I hope everyone is having a great Summer and staying healthy! 

Grain Rain 穀雨 Seasonal Node

As is typical this time of year here in New Jersey the weather has been all over the place lately. Today, Tuesday April 20th, the beginning of the Grain Rain (Gu Yu 穀雨) seasonal node, it is a beautiful Spring day. The temperatures were around 70 degrees (21 Celsius). Tomorrow, true to the name of the node, we are expecting heavy thunderstorms, and Thursday temperatures drop to a high of only about 50 degrees (10 Celsius).

The name Grain Rain refers to precipitation that feeds the grains and other plants for harvest, allowing them to grow to their fullest.  The three smaller segments of the node are Ping shi sheng 萍始生 (Duckweed Begins to Grow), Mingjiu fu qi yu 鳴鳩拂其羽 (Cockoos Flutter Their Wings), and Daisheng jiang yu sang 戴勝降于 (Hoopoes Land on Mulberry Trees) – all images of early plant growth or increased bird activity.

Grain Rain is actually the last seasonal node of Spring since early May marks the beginning of Summer in the Chinese calendar. In only about 2 months the days start getting shorter again – so get out and enjoy the sunshine! Grain Rain is also the 6th step of the 24 seasonal nodes thus corresponding roughly to the Chen (辰) watch of the day (7-9am). It is the time of transition from Spring to Summer correlating to the Soil (i.e., Earth) phase; the Soil phase represents the transition between seasons. Thus, Gu Yu is the time of year associated with the Stomach channel. The general movement of Spring is the movement of Liver-Wood, but the Soil phase is also in charge of movement and transformation. Because of this, during Grain Rain we need to ensure that Qi and Blood are moving smoothly. Watch for signs of Qi stagnation in yourself and in your patients. This is why a good basic recommendation for this time of year is performing regular self-massage to ensure smooth circulation of Qi and Blood in the body.

One of the easiest points to massage for the average person is the collection of points known as the Shi Xuan 十宣穴. These points are located one at the tip of every finger and every toe. The word “Shi” means 10 – there is a point on each finger and toe adding up to 10 total. The word “Xuan” means to spread or diffuse. Since all the channels of the body connect to the fingers and toes, these points together spread or move all the Qi in all the channels of the body, and can be massaged as a general way to prevent and treat stagnation in the channels. To massage simply squeeze and rub the tip of each finger and toe in succession. Repeat throughout the day, but preferably at least once each morning and once each evening.

As the weather does get a bit sunnier and warmer it is good to increase outside activity – consider walking or gardening. However, since Spring is a time of temperature ups and downs (as this week attests to here!), be careful to dress appropriately as dictated by each day. This is also allergy season, for which I suggest using Tung’s Mu (木穴; 11.17) point. Located on the palmar surface of the proximal digit of the first finger, this point is also call the common cold point of the hand (手感冒穴). Since the pandemic is still here, be sure to continue hand washing and mask wearing.

Getting back to the idea of stagnation, it is vital that during Grain Rain we prevent stagnation in the Stomach (since this is the time of Stomach channel). With acupuncture treatment this means making frequent use of Men Jin (門金穴; 66.05), the Tung point overlapping the Shu-stream point of the Stomach channel. It is also important to avoid overeating or over drinking, and the overconsumption of oily and greasy foods.

During Grain Rain start eating lighter and easier to digest items and in-season vegetables such as asparagus. There are also a host of other early blooming plants that are just fantastic seasonal food. In Japan, this is the time for bamboo shoots. Known as Takenoko (竹の子) in Japanese, they are sweet and slightly bitter. Their temperature is cold and they enter the Lung, Stomach and Large Intestine. Thus, they can nourish fluids to treat dryness of the Lungs or intestines.

There are also plenty of lesser known seasonal foods local to the western world. In the Northeastern United States we are at the tail end of fiddlehead season. Fiddleheads are curled fern fronds that have a wonderful fresh flavor similar to asparagus. In Japan and China, bracken (Japanese: こごみ; Chinese: 蕨菜), another type of fern, are also eaten as local fiddleheads there. We cooked some last night in pesto with scallops and they were fantastic! Another seasonal food I’ve recently discovered is magnolia blossoms - the beautiful petals can be quick pickled (we are going to do this tonight). I’ll report back on their flavor later but I’ve heard they are gingery, meaning slightly acrid. Last are ramps, a tasty cousin of the leek, onion and garlic plants. Ramps are native to the Appalachian Mountains, north into Canada, west into Missouri and Minnesota and south to North Carolina and Tennessee. As an Allium, ramps are slightly warming, acrid and sweet – meaning they’re perfect for moving Qi in the Stomach and Liver.

A dish of seasonal vegetables: ramps, fiddleheads, and magnolia blossoms

Other foods to emphasize are those that boost Qi and Blood, and gently strengthen the Spleen and Stomach; the Yang of the Spleen/Stomach is still fragile now, especially since Liver-Wood can over-control Earth. These foods include rice or rice congee, Bian Dou, yams, nagaimo (i.e., Shan Yao), peanuts, and cherries (a slightly warming fruit). If you didn’t know, this is also egg season. Yes… Eggs have a season! Most chickens naturally lay eggs only when day length is about 10 hours or more (commercially grown eggs are available because farmers trick chickens with strong artificial lighting year round). One of my favorite early spring recipes is steamed asparagus with scrambled eggs – delicious and light, and good for you too!

I hope everyone is staying healthy and having a great Spring.

Clear and Bright 清明 Seasonal Node

This time of year Northeast of the US often experiences wild fluctuations of weather. This year that was certainly the case. The past weekend on Saturday morning the temperature was only about 28 degrees during our outdoor Taiji and Qigong classes, and Easter Sunday was warm enough that we ate outside without coats on. Spring is slowly unfolding, although my sakura (cherry tree) has yet to blossom.

 In addition to Easter, yesterday, Sunday April 4th was the beginning of the Clear and Bright (Qing Ming 清明) seasonal node. This seasonal node is also a traditional holiday in much of East Asia – the Qing Ming Festival. In Okinawa, where I lived as a graduate student, the day is called Shimi in the local Hogen (indigenous Okinawan language). Qing Ming Festival is a time for Asians to visit graves and pay respect to the ancestors. Thus it is a time to remember the past while at the same time starting the New Year and the new Spring, showing the beautiful integration and connection between Yin and Yang in all phenomena.

The three smaller segments of Clear and Bright are Tong shi hua 桐始華 (Tung Trees Begin to Blossom), Tianshu hua wei ru 田鼠化為鴽 (Field Voles Transform into Quails), Hong shi jian 虹始見 (Rainbows Begin to Appear). The first of these invokes the image of blossoming trees, as this is also the time for cherry and plum blossoms as early signs of plant life returning.  

When looking at health and the season, the main idea of Clear and Bright is to start with paying attention to the Liver Yang. Liver, the internal viscera of the Wood Phase, is associated with Spring. Yang means several things. First, it is the upward and outward expansion of Qi in the body. Yang is also movement and coursing internally. Lastly Yang means internal heat. All these aspects of Yang will become important for understanding our health during Clear and Bright.

As I mentioned before, the last few weeks in New Jersey have seen dramatic ups and downs in temperatures and weather patterns. Every morning when I wake up I’m thinking the weather should be warmer, but early morning can still be quite chilly. Not surprisingly then, the first “to do” during Clear and Bright is to protect being warm (bao nuan 保暖).  Spring is the time of growing Yang, and we don’t want to do anything that damages that internal warming Qi. The second chapter of the Su Wen admonishes us that if we don’t take care in Spring, then cold disease will arise in the Summer that follows. Since during the next few weeks typically temperatures will continue to fluctuate up and down, be sure to dress appropriately for the day, and not to think that just because it’s supposed to be Spring, that every day will be warm enough for light clothing. 

The second “to do” during Clear and Bright is be active in outdoor activities or exercise. With the continued growth of Yang in the natural world, it is important to increase our physical activity. Again, the second chapter of the Su Wen tells us that in Spring we should be sure to “move around throughout the courtyard with leisurely strides” (廣步於庭). The Wood phase and the Liver are responsible for the normal smooth circulation of Qi in the body, and similarly during Spring we should be sure to keep our bodies moving. Of course, exercise doesn’t have to be intense to be effective. Suggest to patients that just getting outside to do light yard work or gardening is a great idea. Practicing Taiji or Qigong outside is also appropriate.

One of the Nourishing Life exercises that is appropriate to Clear and Bright is pressing and rotating Shen Que REN-8 (i.e., the navel). Shen Que is obviously an important point on the body as the abdomen is the location of many important internal organs. Likewise, it is the area where some of the most important channels in the body originate – the Ren, the Du and the Chong. In Chinese these three extraordinary vessels are said to be “one origin and three branches.” For this exercise first rub hands together vigorously to warm them. Then place the warmed hands over the navel and slowly, with moderate pressure, rotate 50 times in a circle one direction, then 50 times in the other direction. Shen Que rotation helps warm the center and expel cold and is especially appropriate for patients who are cold and depleted, and for patients with clear nasal discharge such as seasonal allergies. Think of doing moxibusion at Shen Que for patients who are particularly or chronically depleted.

The flip side of this is to be cautious of patients with uprising Liver yang patterns, or patterns of internal wind; Clear and Bright is the time to guard against hypertension in patients who are prone to this condition. These patients should be counseled to get some more exercise, as this is an effective adjunct therapy for hypertension.

The “avoids” for Clear and Bright are mainly related to diet. First, Chinese medicine recommends that patients avoid very acrid and spicy foods. While somewhat acrid foods and herbs are appropriate to Spring (such as leeks or scallions), overly spicy foods may potentially either stir internal Yang or dissipate internal Qi. The second type of food to avoid is very sour or greasy foods. Both sour and greasy foods create stagnation, and thus inhibit the normal coursing of Qi. Since Spring is the time of Wood-Liver, it is important to keep Qi moving internally.

In general the diet for Clear and Bright should reflect the name of the seasonal node. Light and clear foods that neither block the Qi mechanism nor overly stimulate it are appropriate. Gentle movement and easy to digest should be the focus. As more vegetables become available, patients should increase consumption of fresh produce. Traditionally this is the time for greens such as spinach and mustard greens. In the west certainly April is the season for fresh asparagus. All these greens are beneficial to the Liver.

Another common issue for this time of year is the beginning of seasonal allergy symptoms. Nearly every day now in my clinic for the last week or so I hear people sneezing and blowing their noses.  Thus, for this seasonal node we can consider acupuncture that treats or prevents this. One of my most commonly used points for seasonal allergies that manifest with sinus congestion, itchy or irritated eyes, red eyes, etc… is Mu 11.17 (木穴). Located on the palmar surface of the first finger, this point is associated with the Lung and exterior, but in particular with external wind. Hence the name Mu, which means “Wood” (wind corresponds to Wood phase). If necessary, people that suffer from vacuity patterns making them more susceptible to allergies can also be needled at Si Hua Shang 77.08 (i.e., Zu San Li ST-36).

In addition to acupuncture that treats allergies, this is the time of the year for basic formulas like Cang Er Zi San. Patients who are somewhat Qi deficient as well leading to being prone to allergies can try making Jade Screen Chicken at home.

Jade Screen Chicken – Yu Ping Ji 玉屏雞

Ingredients:

• 1 whole chicken (about 2 lbs.)

• Huang Qi 60g

• Bai Zhu 20g

• Fang Feng 20g

• Salt and pepper to taste

 Directions:

1. Rinse and clean chicken

2. Take herbs and stuff inside, close chicken to retain herbs inside the cavity

3. Place chicken in a slow cooker and cover with water, allow chicken to cook until done

This can take a long time to cook in a slow cooker, but I think it will yield the best results. I suggest this be set up overnight and put on the low temperature setting. By lunch the next day it should be done as cooking can take 8 hours or more. Other vegetables can be added to this soup as desired. Patients can both consume the meat as well as drink the resulting broth. Season with salt and pepper to taste. The recipe helps nourish Qi, secure the exterior and expel cold.

Herbal Formulas for Spring

Lately I’ve been spending time reading a text called the Zun Sheng Ba Jian (遵生八箋) – the Eight Treatises on Following the Principles of Life. Written by a scholar by the name of Gao Lian at the end of the Ming Dynasty (1368-1644), the text is an almost encyclopedic collection of all manner of Nourishing Life (養生) recipes, techniques, theories, etc… One section discusses seasonal health, and includes commonly used seasonal recipes, such as this one for Spring:

Chrysanthemum Powder 菊花散

Ingredients: Ju Hua, Qian Hu, Xuan Fu Hua, Bai Shao, Xuan Shen, Fang Feng; each 30g

Instructions: Grind all ingredients to a fine powder. Take 6-9g of the powder as a dose, consumed with wine (i.e., alcohol). For those sensitive to alcohol take with thin congee, or hot water.

Comments: The original text says this formula is good for elderly people to use in Spring, and can treat wind and heat patterns in the upper body, neck pain, headache, swollen face, and red and irritated eyes. Sure sounds like allergy symptoms to me! In this formula the Ju Hua, Qian Hu, and Fang Feng treat the exterior. Xuan Fu Hua directs Qi downwards as well as assists in treating the exterior. The last two medicinals, Bai Shao and Xuan Shen, nourish the Yin and Blood, and Xuan Shen also assists in treating red and swollen eyes. So, give this formula a try when it seems appropriate.

Happy Spring everyone!

Henry

Sakura 桜

Spring is slowly unfolding this Easter weekend, despite the below freezing temperatures we experienced during our outdoors Qigong and Taiji classes this morning. I’ll post soon about the Qing Ming node (which also falls this weekend), but I wanted to share some great photos an old friend sent me. She is a Buddhist priest who runs a small temple near Kyoto. These are the cherry blossoms in bloom from her temple from earlier this week. In Japan going to see cherry blossoms is a very important cultural event, known as Hana-mi (花見; lit. looking at flowers). I have very fond memories of my first year in Japan, now over 25 years ago, going to Kyoto with my host family to sit under the flowers for a picnic.

Happy Easter to all (and a belated Passover)! Enjoy the wonderful unfolding of Spring…

The Five Taxations 五勞 - Part V

The word taxation (勞) as a medical term refers to some sort of physical exertion, or fatigue resulting therefrom. It also can describe some sort of significant wear and tear on the body. Previously I had blogged about a list of Five Taxations from the Xuan Ming Wu Qi (Wide Promulgation of the Five Qi, Su Wen 23).  This is the last installation on the Five Taxations and it is long overdue. For those who are new subscribers or who missed the last posts, the first was taxation that involved the Heart, the second the Lung, the third the Spleen, and the fourth the Kidney. As is typical with the Neijing the five track along the Five Phases and thus the Five Viscera.

The last of the Five Taxations goes with the Sinews and the Liver. The source chapter says, “to walk for a long time damages the sinews” (久行傷筋). Wang Bing points out here that this then relates to the Liver. Like the previous taxation, there is little other explanation with my Translation and Explanation of the Neijing Suwen adding: 过度的行走，可以伤筋 (“excessive walking can injure the sinews”).

Now, I think most of us would consider walking a great form of exercise that just about anyone can do, and this is true. It has lower impact on joints than running, and it is easy and convenient. Medically though, we do know that overdoing anything is a problem. Remember, that the word in Chinese for ‘Chinese Medicine’ is Zhong Yi 中醫. The first part of that word, Zhong (中), stands for China (Zhong Guo 中國). However, Zhong literally means center, or middle. Thus, Chinese medicine is literally medicine of staying in the center. One of the core fundamental teachings of Chinese medicine, as illustrated by all five of the taxations, is that balance, in other words staying in the center, is health. Lack of balance is disease. This is why the Ping Ren Qi Xiang Lun (Su Wen Chapter 18) says that “a balanced person has no disease” (平人者不病也). Even with walking, overdoing it can be problematic. Endurance walking in particular is known to possibly cause dehydration, blisters on the feet, and, just as this taxation suggests, muscular pulls, strains, or other injuries.

At this moment I’ll remind everyone that the word Sinew in Chinese medicine is not the same as tendon in western medicine. The Chinese word sinew (筋) can refer to tendons and ligaments, but is also refers to the contractile strength of skeletal muscle. This is why in the middle of that character we see the character for physical strength (力).

In addition to the literal reading, we can try to understand this taxation in a deeper way. Sinews and Liver go with the Wood phase, the architype of Spring. Spring is the beginning of movement, the movement of rebirth, and thus ultimately a Yang season. While the taxation of sitting too long (i.e., lack of movement) damages the Spleen, we can also see that lack of movement damages the Liver and sinews as the symbolic representation of the muscles and connective tissue. Too much movement is also problematic. In that case, too much Yang-movement damages the physical manifestation (Yin) of the Wood-Liver (Yang).

Looking at this taxation in the other direction is also possible. As the Yang declines with the aging process, people are less inclined to move. In the 54th chapter of the Ling Shu the ageing process actually starts with a decline in Liver. And in the very first chapter of the Su Wen tells us that, “as the Qi in the Liver weakens, the sinews no longer can move” (肝氣衰，筋不能動).

So, how do we work with this taxation clinically? The first thing is to counsel patients to be active, but not to be so active as to constantly injure themselves. If your clinic is like mine, this is a constant issue really. How many times do we have a patient come in with shoulder, neck or back pain (or any other type of musculo-skeletal injury) that is a direct result of some overdone exercise? After we treat them and they feel better, often the first thing they do is go right back to the offending exercise and reinjure themselves. Like Chinese medicine at its fundamental level, we need to tell patients to seek balance in movement and rest, activity and stillness. Some patients need to exercise more, but some actually need to exercise less. A lot need to vary exercise so as not to constantly stress the same body areas.

For weakness of the sinews in general manifesting as weakness in moving the limbs, pain in the joints, and intolerance to exercise, I recommend Tung’s points the Lower Three Emperors (下三皇). This is an important Dao Ma combination on the lower leg that has a strong regulatory effect on the Kidney. Why do we use the Kidney here? Because strengthening the Kidney-Water benefits the Liver-Wood, conforming with the Nanjing strategy of “in vacuity supplement the mother” (虛者補其母). We can combined the Emperors with Yang Ling Quan (GB-34), the meeting point (會穴) of the sinews.  Specific locations of weakness can be addressed individually with other points in addition to this general method of strengthening the Liver (via the Kidney) and benefitting the sinews.

I hope everyone has enjoyed this short series of essays, and that they show what sort of great knowledge is embedded in our classical texts!

Vernal Equinox 春分 Seasonal Node

Going back over my blog posts I realized that I didn’t write anything for Vernal Equinox last year; I ended up missing quite a few of the seasonal nodes. At that time we were in the beginning of the global pandemic that still lingers, although here in the greater NY metropolitan area at this time last year we just about to enter the height of infections and patient deaths. Many patients who were regulars in my clinic had severe cases of COVID-19 that landed them in hospital ICUs, and some patients died from the infection. Last year at this time was also when I stopped going into New York to teach, and when I stopped seeing my Taiji master on a weekly basis.

However, this March I am a bit more hopeful. The last year has been particularly difficult, with the health and economic fallout of the pandemic. After a year of online teaching I am more appreciative of what we miss when we are not teaching in person (I am thankful for my ongoing Taiji and Qigong classes which we have had in person, although outside in some very cold weather recently, since last July). The upside of online teaching though is that we can connect those who cannot possibly be together in the same room – my online Qigong classes have regularly included friends and students from as far west as California, and as far East as Europe. That has certainly been wonderful. I am hopeful now that vaccine rollout is happening, and that we have a new administration that is finally taking the pandemic seriously. This week in my class on Asian history and culture in relation to medicine we discussed the long history of variolation in China. Despite what we see being thrown around on FaceBook these days, it is clear historically that variolation (and then vaccination) was an important part of Chinese medicine for at least the last 500 or more years.

I think my rising optimism is also timed well with the seasonal shift we are now experiencing. Early tomorrow morning, at 5:37am Eastern Daylight Time, we hit the astronomical Vernal Equinox. This is also the beginning of the 2 week long seasonal node of the same name.

In the Chinese calendar we are in the middle of Spring, but in the western calendar we celebrate Vernal Equinox as the beginning of Spring. In Persia this day was traditionally revered as the beginning of the year (called Nowruz), and Rosicrucian mystics count Vernal Equinox as the New Year as well. Why then does the Chinese calendar regard Vernal Equinox as the midpoint of Spring? Because we are now at the balance point of Yin and Yang. If the height of Yang is the longest day (Summer Solstice), and the height of Yin is the longest night (Winter Solstice), then the midpoints and thus points of balance are the Equinoxes. Even though the weather is still cold and there is snow on the ground, the gradual awakening of all life in nature is clear. 

The three 5-day periods in this seasonal node are Swallows Arrive (xuanniao zhi 玄鳥至), Thunder Starts Resounding (lei nai fasheng 雷乃發聲), and Beginning of Lightning (shi dian 始電). In Yijing (I Ching) theory the Thunder Trigram (Zhen Gua 震掛) is a Wood trigram, linking thunder and lightning, yang activities of the heavens, with Spring. Zhen Gua is composed of one solid yang line on the bottom, with 2 yin (broken) lines above. This is the image of Yang emerging from underneath, continuing to grow up and out. Spring is exactly that time of year – the time when Yang of the natural world is slowly starting to push itself up and out of the Yin of Winter.

The main thing to focus on during this 15-day period is “Nourishing the Liver” (yang gan 養肝). One of the ways we nourish the Liver is to ensure normal Liver function. For example, this is the time of year to really ensure our patients' Qi is freely coursing (one of the main functions of Liver is to ensure normal coursing of Qi). The second “to do” during this time is to “both Clear and Supplement.” This means that when the Liver is hot or hyperactive, clear and sedate. When it is vacuous (e.g., has Blood vacuity), then supplement. Since any pattern of disharmony in Liver will impair some of its major functions, when we see Liver patterns during this seasonal node they must be treated. That said, this year, at least here where I am located, the weather is still chilly, especially in the mornings. As such we may have to protect the warm-Yang in the body at the same time we clear Liver or supplement the Yin-Blood. A beautiful example of this is harmonizing formulas such as Xiao Chai Hu Tang, or even Xiao Yao Wan. Both contain herbs that strengthen and supplement (e.g., Ren Shen, Bai Zhu) along side of herbs that course or clear Liver. We can also consider giving our vacuous patients pill-form warming and supplementing formulas along side of powders or decoctions that have a more Liver coursing or clearing function.

As mentioned already, the Vernal Equinox is the time of balanced Yin and Yang. It is appropriate at this time to also have balanced mind states. Thus, one of the “avoids” during the Vernal Equinox is extremes of the Seven Affects. Chapter two of the Su Wen says that Spring is the time to not be angry. We should try to relax, and not allow our emotions to run too far in any direction. The second thing to avoid during this seasonal node is overdoing “bedroom activity.” Since sex stirs the Yang to mobilize Jing-essence, to keep an overall balance in health we need to seek a balance in sex. As this time of year is a time of balance, too much sex may deplete the Yin-Jing. That said, no sex at all can lead to stagnation in the circulation of Qi and Blood.

Diet for Vernal Equinox

Diet for the Vernal equinox should mimic the balance that is present in nature at this time. In general, the continued use of mildly acrid foods such as ginger and scallions help ensures normal coursing of Liver qi. This is especially useful for patients with Liver depression patterns. Patients who tend more towards vacuity patterns, especially Liver blood insufficiency, can increase consumption of sour foods such as pickles or vinegar. This year since the weather is cold though, we should continue to eat slightly warming foods. However, it is best to avoid very greasy or cloying warm foods (such as an overconsumption of very fatty meats), or very salty meals. While salty and more greasy is ok in the cold of Winter, right now in Spring we need to be concerned with the normal and smooth movement of Qi and Blood in the body. The basic combination then is warming and acrid, such as the aforementioned ginger.

A simple tea most patients can consume during this time is rose bud tea. This tea is made by steeping Mei Gui Hua 玫瑰花 in hot water. Mei Gui Hua is warm and sweet and is found in the Qi regulating chapter of the Materia Medica. It courses Liver as well as gently quickens the blood. It is especially useful for our female patients who have menstrual irregularities due to Liver stagnation. In the Baijiquan 八極拳 system of Chinese marital arts, Mei Gui Hua tea is used as a general Qi and Blood moving tea for injury. For patients who suffer from more internal cold, Mei Gui Hua can be combined with Gui Zhi (cinnamon twig) or Sheng Jiang (fresh ginger).

One traditional dish for Vernal Equinox is Stir Fried Pig Kidney with Eucommia (杜仲豬花). Here’s the recipe: 

Ingredients:

• Organic pig kidney ¾ to 1 lb

• Eucommia bark (Du Zhong 杜仲) 6-9g

• 1 scallion, 1 piece of ginger (about the size of your thumb or a little larger), 1-2 cloves of garlic

• Cooking oil, salt, soy sauce

 Instructions:

1. Cook Du Zhong in about 1 cup of water by bringing to a boil and then simmering until only about ½ cup of liquid is left

2. Cut kidneys into thin slices and then score one side of each slice; peel and slice the ginger, slice the garlic, and slice the scallion

3. In a pan, add a small amount of cooling oil, and start by cooking the garlic and ginger just until fragrant and / or the garlic is transparent. Add in the kidney slices and cook for several minutes. Then add a small amount of salt and soy sauce.

4. Add in the Du Zhong liquid, and cook down in the pan with the kidney. Add scallions. Cook until kidneys are thoroughly cooked through.

5. Optionally one can add Gou Qi Zi (i.e., Goji berries) at end as well before liquid has cooked down, cooking until slightly plump.

This recipe supplements the Kidney, boosts essence, and nourishes the Liver blood. It is good for lower back pain, knee pain, declining visual acuity, or other symptoms of Liver and Kidney vacuity. Because it is warming it is especially useful this year!

Acupuncture for Equinox

 When considering acupuncture recommendations, first we should think about how Wood phase (for Spring) is functioning in our patients. Ideally, we should all be in a state of balance, neither in a state of insufficiency nor of repletion. Relative repletion, especially during the time of transition into warmer weather, frequently manifests as stasis. This is because the Qi of the body, as the time of year is becoming more Yang, wants to move. But since cold weather is still lingering, Qi has trouble moving and stagnation is the result. Another possible reason for stagnation is a failure to increase physical movement this time of year. If this is the case then points that course Qi and Blood throughout the body should be chosen. My recommendation is to consider the Metacarpal Three Needles (掌三針) consisting of Ling Gu 22.05, Da Bai 22.04 and Zhong Kui. On the lower extremities we can add Ren Huang 77.21. If the repletion also manifests with some internal heat, consider bleeding the apex of the ear.

The opposite situation is having a patient with insufficiency of Wood, either in the case of Liver Vacuity (especially patterns of Liver Blood vacuity), or of general vacuity of the Yang. For Liver vacuity we can consider points such as the Upper Three Yellows (上三黃; 88.12, 13, 14). Alternately, we can choose the Lower Three Emperors (下三皇; 77.17, 19, 21), one main Dao Ma group for the Kidney. Why the Kidney Dao Ma group? Because strengthening Water-Kidney automatically strengthens Wood-Liver because of the Five Phase engendering cycle relationship.  

I hope everyone will have a great Equinox. Stay warm, stay healthy, and keep wearing your facemasks!

Chinese New Year Online Course Sale

To celebrate the Chinese New Year Healthy Seminars (formerly Pro D) is giving us their first sale of 2021. All courses (including mine) are 30%! Click on the image below to go to my class, or to browse other classes that are available.

Happy Lunar New Year - Year of the Metal Ox!

新年快樂

恭喜發財

Today is the beginning of the new Chinese lunar year. We are now ushering in a Xin Chou (辛丑) year, which really more properly started last week with the Seasonal Node – Beginning of Spring (there is both a lunar and solar new year in the Chinese calendar). Xin is the eighth Heavenly Stem associated with Yin Metal, and Chou is the second of the Early Branches. The Chou branch is Yin Soil associated with the Ox zodiac. Thus this coming year is the Yin Metal Ox year!

I’m not going to be foolish enough to make any predictions about how this year is going to go - we saw where that got us this last year. But I will take some time to talk a little about the moon and Chinese medicine.

The lunar new year always starts on a new moon, so to start the new year off I thought I’d take a break from seasonal nodes and talk a little today about lunar cycles and acupuncture. This semester I’m also back to teaching a course on the philosophical and historical foundations of Chinese medicine, and at every class we’ve had so far I’ve told them it all comes back to Yin-Yang and Five Phases. Lunar acupuncture, like everything else we discuss, illustrates this principle.

Clearly ancient physicians thought that knowledge of the changes in the natural world were an essential foundation to practicing medicine. This is why in Su Wen Chapter 9 it says, “He who does not know what a year contributes [to human health], how the qi abound and weaken, and why repletion or vacuity arise, they cannot serve as a practitioner [of medicine]” (不知年之所加，氣之盛衰，虛實之所起，不可以為工矣). In this sentence the word year refers to the cyclical fluctuations of time based on movement of the heavenly bodies such as the sun, moon and stars. In our Seasonal Node posts we talk a lot about the longer term changes in time and weather, but we don’t talk as much about the shorter cycles such as the moon.

Su Wen Chapter 26 (Ba Zheng Shen Ming Lun) gives us a discussion of what is sometimes called Taiyin Needle Methods (太陰針法). Taiyin, Greatest Yin, means the moon. This chapter says, “at the time of the beginning crescent moon, blood and Qi originate as jing-essence, and the guard qi begins to move” (月始生，則血氣始精，衛氣始行). The commentary to this line by Yang Shang Shan says that at the new moon Qi and Blood are in the stage of being created again. This, like the Winter Solstice, is the birth of Yang. But since during the new moon the cycle is at its most Yin (where Yang is reborn), it is a time of cold and insufficiency.

The moon is a symbol of Yin, and in the body Yin can refer to the actual physical substance of our being. Thus, in the same chapter of the Su Wen it says, “when the disk of the moon is full, blood and Qi are replete; the muscles and the flesh are firm” (月郭滿，則血氣實，肌肉堅).  Based on these quotes we find this treatment recommendation: 

“As the moon starts to wax, do not drain. At full moon, do not supplement. When the disk of the moon is empty, do not treat.” 月生無寫，月滿無補，月郭空無治

During the Yin time, the new moon, it is therefore appropriate to supplement and not drain. Moxa at Zu San Li (ST-36) is appropriate as regular preventive treatment on the day of the new moon. In the clinic I am less likely to apply bloodletting therapy on a new moon, unless the patient is clearly replete and hot. On the other end of the spectrum during the full moon bloodletting is often more effective and also safer to apply in patients with mixed patterns where pure repletion may not be the presentation.

The wonderful thing here is that nothing in these recommendations should surprise us as long as we keep Yin and Yang in mind. So, today go do some moxa on Zu San Li, eat vegetarian (for the new year), and try to take it easy a bit. Happy New Year, and happy Spring. For those who want to learn more about Chinese medicine and acupuncture’s relationship to time and the seasons can see my online class on the topic (click here).

My best wishes to all for a very happy new year!

Beginning of Spring 立春 Seasonal Node

It has been a very snowy last few days here in the US Northeast. I think we ended up with just under 20 inches of snow over the last two days. When I got back to the clinic today (it was closed Monday and Tuesday), there was a pile of snow in the parking lot at least 4 feet tall. It has also been cold. My dog is not in the habit of coming downstairs in the morning and lying in front of a radiator before he’s willing to go outside for his morning constitutional. Yet, something is changing in the air. Albeit cold, we are in a time of seasonal transition, with the promise of warmer weather to come. Yesterday, Groundhog Day, Staten Island Chuck predicted an early Spring (although Punxsutawny Phil disagreed). However, despite contrary predictions, in the Chinese calendar today, February 3rd, is the beginning of Spring.

While westerners are accustomed to placing the beginning of Spring in March, the Chinese calendar marks time more by relative daylight. As the days are now getting longer, we are in the time of everything waking from Winter’s slumber. The darkest and longest nights are now 6 weeks behind us, and in only another 6 weeks we will be at the Equinox – half way to when the days will get shorter again.

The Chinese use both a lunar and a solar calendar to mark time, and because of this there are two dates that are considered the beginning of Spring. One is called Li Chun (立春) – the “Beginning of Spring,” which is one of the twenty four seasonal nodes. The solar beginning of Spring happens every year in early February and this year it starts today (February 3rd). The other beginning of Spring is the lunar, also known as Chun Jie (春節), the Spring Festival. This day is the Chinese Lunar New Year, and it falls on the second new moon following the Winter Solstice (with the rare possibility of it falling on the third new moon in some years with an intercalary month). The Lunar New Year is one of the most important traditional holidays in China, and is a time for people to visit with family and friends.  The lunar festivals traditionally last about 2 weeks until the full moon. This year the Lunar new year starts next week, on February 12th.

 During the Beginning of Spring seasonal node the Yang influences are growing in the natural world. As mentioned already, we are only about 6 weeks away from the Vernal Equinox (Chun Fen 春分), one of the two times of year when the Yang and Yin are balanced and we have more equal day and night. Even with cooler weather lingering the days are getting longer and in northern New Jersey where I am, in the morning I am hearing some songbirds starting to return.  The increased activity in the natural world are also reflected in the names of the shorter 5 day segments (the 72 Material Manifestations of the year) that make up Beginning of Spring – Dong Feng Jie Dong 東風解凍 (The East Wind Liberates From Icy Shackles), Zhe Chong Shi Zhen 蟄蟲始振 (Hibernating Insects Begin to Stir), and Yu Shang Bing 魚上冰 (Fish Rise Up to the Ice).

Beginning of Spring is the time of year for new beginnings. It is also time to continue growing the ever-expanding Yang in our bodies so as to mimic the expanding Yang in the natural world. One of the basic health exercise recommendations for Beginning of Spring is to frequently comb the hair (or head if there is no hair). In Chinese, this is called Shu Fa 梳法, or “combing therapy.” Combing therapy has been around since at least the Sui dynasty, and is found in both Yang Sheng texts as well as Tuina manuals.

To apply Combing Therapy comb the hair (or scalp) daily, 100 times each sitting. This can be done either in the morning upon waking or in the evening before bed, and the traditional recommendation is to use a comb of either bone or wood. That said, simply combing with the fingers is even more effective since the fingers are living and contain Qi, which bone and wood do not. This is such a simple exercise that anyone can be taught to do it.

Combing has several functions. By stimulating the head we are stimulating the top of the body, meaning the most Yang area of the body. Since Spring is a time of Yang growth and expansion, stimulating the Yang area of the body is appropriate. Gently working the surface of the body also stimulates Wei Qi movement in the head and channels of the head. This in turn helps expel wind, and avoiding wind is one of the basic “avoids” for the Beginning of Spring. Furthermore, the scalp is a microsystem of the entire body, so stimulating the channels on the scalp mobilizes Qi and Blood in the entire body. 

Spring is the time associated with the Wood phase and the Liver, and the Liver is a Yang viscera (with Heart being the other Yang viscera). A traditional saying for Beginning of Spring is “Li chun yang gan shun tian shi, qu chu ji bing bao jian kang” – “At the beginning of Spring nourishing the Liver means to following the timing of Heaven, expel and rid yourself of disease and protect your health.” Diet recommendations at the Beginning of Spring then are designed to help and nourish Liver. 

As a general rule this is the time to consume foods that help maintain normal Liver function, especially the Yang of Liver. Since the Liver governs free coursing, eating mildly acrid and warm foods will support this function. For example, appropriate foods this time of year include scallions, leeks, chives, cilantro, and garlic.  Here is another phrase for this time of year: “Duo chi jiu cai chao rou si, yang hu gan yang zhu sheng fa” – “Eat a lot of leeks and pork to nourish and protect the Liver yang and develop the nature of birth.”  In the Huang Di Nei Jing the Spring is associated with the term sheng 生 or “birth.” This is the same sheng as in, for example, Sheng Jiang 生薑 – fresh (or living) ginger. Tung recommended eating beef stewed with garlic for the treatment of Liver Vacuity (Tung, 1973). While he didn’t mention it specifically for Beginning of Spring, we can say that this recipe is perfect for the warming and strengthening of the Liver Yang that is now appropriate.

Patients with chronic Liver fire should take care this seasonal node as Yang is on the rise everywhere. A traditional Beginning of Spring drink for these patients is Yin Chen Da Zao Tang. For this drink take 20g of Yin Chen Hao and 30g of Da Zao. Place in a pot with about 2 ½ cups water. Bring to a rapid boil then reduce and simmer for 30 minutes. Separate into 2 doses and drink in the morning and evening. This formula benefits qi, generates fluids, and protects the Liver. In the clinic we can mimic this basic formula with points such as Mu Yan 11.20 or Gan Men 33.11.

One more traditional dish for Beginning of Spring is Pork Bone Red Date Soup. Yes, even before bone broth became the latest health trend here in the US, it was considered an important food for health the world around. This dish can be taken daily; it builds blood, warms the interior without being too warming or drying, and can be taken both to prevent and treat colds.

Pork Bone Red Date Soup 豬骨紅棗湯

Ingredients:

• Pork bone, about 3 lbs

• Chinese dried red dates (Hong Zao, or Da Zao), about 6 pieces

• Ginger

• 1 Large scallion white

• Salt

Instructions:

1. Place washed pork bones into a slow cooker and add enough water to cover bones (about 2 quarts)

2. Cut ginger and scallion into large pieces, place in slow cooker with bones; add dates as well to slow cooker

3. Cook on low for 8 hours or more (the prep can be done in the evening and left to cook overnight)

4. Drink broth daily

Other vegetables or ingredients can be added to this soup as desired. To read more about general Spring health care please click here.

Happy Spring! I’ll blog again for the Lunar New Year next week.

Major Cold 大寒 Seasonal Node

Last week Wednesday, January 20th was the start of the Major Cold (da han 大寒) Seasonal Node. This year the overall temperatures have been slightly warmer than many Januaries, but the last few days have been cold. This past Sunday I cancelled our outdoors Qigong and Taiji classes because of the cold, and today we had some winter precipitation although it looks like we’ve missed any significant snow accumulation. This time two years ago we were having overnight highs of about 8 degrees (-13 degrees Celsius). That’s really the spirit of Major Cold!

The days are slowly getting longer, and this morning as went out early to practice Qigong birds were singing more than they were even just a few weeks ago. The bird songs were a reminder to me that Major Cold is the last node of the traditional Chinese year, and we are only a few weeks away from the both the Lunar and Solar New Years, and the Beginning of Spring seasonal node.

The three material manifestations of Major Cold are Hens Begin to Breed (Ji Shi Ru 雞始乳), Birds of Prey Act Fierce and Swift (Zhi Niao Li Ji 鷙鳥厲疾), and Rivers and Lakes are Frozen Within (Shui Ze Fu Jian 水澤腹堅). Notice here imagery of the impending Spring. In Five Phase theory the domestic animal associated with Spring is the chicken, and during Major Cold hens are getting ready to become pregnant with baby chicks that will hatch in Spring. Thus, even though the weather outside is still very cold, Yang is definitely on its way back as the gradually lengthening of the days attests to.

As the name suggests, the Major Cold Seasonal Node is the time of the year when the main environmental factor we contend with is cold. The first thing that Chinese medicine recommends for this time is to eat clear and easily digested foods (qing dan shi wu 清淡食物). Why is this? The Spleen and Stomach are the roots of Latter Heaven Qi. During the end of Winter even though the time of the year is still predominantly Yin, the Yang qi is being birthed. Eating clear and easily digested foods allows the Spleen and Stomach to move and transform appropriately, and to build Latter Heaven Qi. If foods are too heavy, overly greasy or overly sweet, then the ability of the Spleen and Stomach to move and transform is impaired. Easy to digest foods ensures that we continue to build Latter Heaven Yang Qi to get ready for the upcoming spring.

In addition to cold, the other main environmental pattern seen during Major Cold is dryness. Even with some wet snow and sleet on the ground this morning, lately my patients have been complaining of dry skin on an almost daily basis (this is even more so this year because during the pandemic we are all washing our hands more than usual). However, much of the environmental water is now bound up in snow or ice, making the air dry. Knowing this, the second recommendation this time of year is to stay warm but also be sure to not be too dry. Staying warm is obviously important in this time of greatest cold. But since certain organs are harmed by excessive dryness, such as the Lungs, we need to be vigilant there. For example, for those with forced hot air heating systems, it may be prudent to run a humidifier periodically. Sipping warm liquids such as herbal teas throughout the day can also keep our internal environment appropriately moist. Interestingly, too dry of an environment can also be tied to increased COVID-19 transmission. As a lipid-enveloped virus (like most respiratory viruses including other coronaviruses, influenza, and respiratory syncytial virus) it survives longer at a lower relative humidity.

With patients who are cold, or have Spleen or Kidney vacuity patterns, continue to warm and supplement. Moxibustion, especially at points like Zu San Li ST-36, Qi Hai REN-6 or Guan Yuan REN-4 is still appropriate. Acupuncturists can include Tung’s point San Cha San 三叉三穴 frequently in point prescriptions. This point has the ability to warm yang and supplement the Kidney. Furthermore, since it pierces through Ye Men SJ-2, “Fluids Gate,” it benefits fluids, particularly of the upper orifices.

As already mentioned, during Major Cold we should emphasize consuming easily digested foods that protect internal warmth and strengthen the middle. Foods that satisfy this requirement include, for example, rice, glutinous rice (in moderation), yams (including nagaimo), peanuts, clear soups like chicken soup, and cooked vegetables. In general avoid raw vegetables, cooling fruits, very greasy meats, and very sweet deserts. When cooking make frequent use of fresh ginger, and other mildly warming spices like nutmeg.

In addition to protecting the Spleen with food, during Major Cold it is also important to consume foods that guard against dryness, and in particular Lung dryness. To this end traditional recommendations for food include consuming white wood ear mushrooms (Yin Er 銀耳) and pears, especially Asian pears.  A great traditional tea for Major Cold is Goji Berry and Red Date Tea (枸杞大棗茶). To prepare, take about 1 teaspoon Goji Berries (Gou Qi Zi) and 3 small red dates and place in a large mug. Cover with boiling hot water and let steep at least 5 minutes. After drinking about ½ the mug, refill once or twice more with boiling hot water. This tea supplements and moistens the Kidney and Liver, nourishes blood and supplements the Spleen.

Another good recipe for Major Cold comes directly from Tung’s writing. In his 1973 book on Tung’s Acupuncture he includes a chapter on dietary therapy. While not specifically listed for Major Cold, one of the recipes he gives is for pork kidney steamed with ginger strips. This simple dish treats kidney vacuity with dryness, manifesting for example with dry mouth.

As I’ve mentioned in some previous posts, since I do so much acupuncture in my clinical practice and I teach Qigong regularly, I really like channel based Yang Sheng practices in addition to lifestyle and diet that we usually discuss. One traditional recommendation for Major Cold is foot soaking and acupressure to support some of the goals we’ve already described above. The time of day associated with Major Cold is the Chou 丑 hour (1-3am). While I don’t recommend staying up too late, this practice can be done before bed, as close to that time as possible while still getting to sleep at a reasonable hour. Start by soaking feet in hot/warm water for 10-15 minutes, and Epsom salts can also be added to the water if desired. After that follow the soaking with acupressure on Yong Quan KD-1, Tai Bai SP-3 and Tai Yuan LU-9. This helps warm and strengthen the Kidney channel, and supplement the Spleen and Lung channels thus corresponding to some of the basic recommendations discussed above.

The last recommendation I’ll offer is gentle massage of the lower back. We all know that the low back is the abode of the Kidney, and gentle stimulation of the low back can thus relax and warm the Kidney. Furthermore, Major Cold is specifically associated with the 3rd lumbar vertebra. There are 24 total vertebrae corresponding one to each of the seasonal nodes, and this association is well known in esoteric Daoist circles. In the White Cloud temple in Beijing there is a diagram of the body carved in stone on the side of one of the walls that maps out the associations of the vertebrae with the nodes. So, in light of that correspondence, one great Yang Sheng practice for Major Cold is to sit quietly, starting with vigorously rubbing the palms together to get them as warm as possible. Then, place the hands on the low back in the area of L-3 feeling the warmth of the hands penetrating the back. After that rub the back to warm the area, or gently tap the low back.

I hope everyone is staying warm, and I’ll be back blogging next when Spring arrives!

Stone plaque at the White Cloud Temple (Beijing) showing the inner view of the body. The spine shows each vertebra as being related to the 24 Seasonal Nodes.

Close up of the same plaque showing the lower spine where Major Cold is found.

Cold Season Blue Garlic 臘八蒜 (Repost)

This is a blog post I wrote last year around this time. I just finished making a batch of this garlic today, so I thought it a good time to repost! When I originally wrote this I couldn’t have anticipated what the rest of 2020 would bring. While I used to be able to visit my Shifu weekly, it has been much more sporadic over this last year. It reminds me to be thankful of the time we have with some people - that precious time spent may not be possible at all times. Once this year’s batch of garlic is ready to eat, I’ll enjoy the flavor as well as the memories and connections it represents.

Anyone reading this blog knows that seasonal foods are a big thing in China. Actually, seasonal foods are a big thing in all cultures except for the modern west where we can have anything we want at any time of year. Today I thought I’d talk about a simple and delicious traditional side dish.

Drinking tea with Master Wang, our regular pre- and post- training ritual.

Most Fridays I visit with my Taiji Shifu 師父, Wang Fengming, and we train together. Last week after training I stayed for dinner and had my first experience with cold season blue garlic that was made by my Shimu 師母, Mrs. Feng (she is one of Grandmaster Feng Zhiqiang’s daughters).

I had never seen this food before, but it is commonly made in the north of China during the cold season. It is a type of pickled garlic that actually turns bluish (see the photo below), and in Chinese is known as Laba Garlic (là bā suàn 臘八蒜). Laba is a traditional holiday on the 8th day of the 12th lunar month, celebrating the date of the Buddha’s enlightenment. Being in the 12th lunar month it usually falls around the Minor or Major Cold Seasonal Nodes, in other words, one of the most Yin times of the year.

As a food, garlic is quite warming. Its flavor is acrid and sweet, representing the dual functions of being able to move and supplement Qi. It has a Spleen and Stomach strengthening and warming effect, and it moves stagnation to aid the digestive process. The time we are in now is a transition between Winter and Spring (which starts in less than a month from now), and the transition times are associated with the Soil/Earth phase – thus the Spleen and Stomach. However, the weather is clearly still cold, with the exception of the unseasonal warmer temperatures predicted in New Jersey this weekend. Our general dietary strategy this time of year therefore should be to warm and protect the Spleen and Stomach. We can also do this with acupuncture, moxibustion, or herbs as I’ve described in other posts recently.

Raw garlic is too harsh for most people to want to eat. Cold Season Garlic is a type of pickled food that becomes mild enough to be eaten as a side dish, often traditionally with dumplings. The vinegar used to make it can also be eaten on dumplings, or just about anything else that uses vinegar.

Finished Cold Season Garlic with some of its pickling vinegar.

To make, start by taking a desired amount of garlic, and separate and peel to cloves. Place in a clean jar and simply cover the garlic with good quality aged Chinese vinegar (some recipes add sugar, but it is unnecessary). Let sit either at room temperature or in a refrigerator for at least 3 days, although longer storage in the vinegar is fine. Within several days the garlic will start turning blue-green, and after that it can be eaten at any time. And the flavor is fantastic! Use as a side dish to dumplings, meats, any type of vegetable, or with morning congee.

I’ll be blogging about the Major Cold Seasonal node sometime soon.

Minor Cold 小寒 Seasonal Node

It certainly has been a crazy week and I have to admit I don’t have the mental energy to post new material for the current seasonal node. I think most of us reading this blog are alarmed by the actions of the most extreme demagogue in American history, and the person who is the biggest threat to the American democratic system and even world peace that we’ve seen in decades. Scenes from this week have shaken the world and I hope we can eventually claw ourselves back to something we can be proud to leave our children.

So, instead of a new seasonal node blog post, I’ll just repost last year’s. Everyone please stay safe (especially those of you who are health care providers), and let’s hope for the best in the coming weeks…

After Winter Solstice there are only two more Seasonal Nodes in the Chinese calendar before the Chinese Solar New Year and the beginning of Spring - Minor Cold (小寒) and Major Cold (大寒). As is clear from the names, temperature is an important part of understanding the last two seasonal nodes of the traditional Chinese calendar. Today as I woke up before coming into my clinic we had a dusting of snow. Even though the temperatures are not frigid, it is definitely cold! What is more important is that now is the time of year when the potential for sustained cold is very real as, even though we are moving into Spring, January and February are usually the coldest months of the year.

This year Minor Cold (小寒) starts today, January 6th [n.b., in 2021 the date was January 5th]. In 2020 this is one day after the Earth being in perihelion, the exact day when the planet is closest to the Sun. Perihelion happens each year about 2 weeks after the Winter Solstice, however the warmth of the season is determined by angle of sunlight, not proximity to the Sun, which is why even though we are close, it is still cold.

The three shorter breakdowns of Minor Cold, the material manifestations, are Geese Head North (Yan Bei Xiang 雁北向), Magpies Begin to Build Nests (Que Shi Chao 鵲始巢), and Ring Necked Pheasants Begin to Crow (Zhi Shi Gou 雉始雊). In Chinese there is a saying that goes “Xiao han da han, leng cheng bing tuan” 小寒大寒冷成冰團 – “Minor Cold and Major Cold, coldness is here and ice abounds.” The previous seasonal node was Winter Solstice, the time of the year when Yang qi is born again in the natural world. However, despite the growth of yang this month continues to become colder and colder. Why does cold continue to worsen even though we are moving to the Yang phase of the year?

Think of the movement of temperature as being driven by the fluctuations of yin and yang in the natural world. Even though the “switch” has been flipped from yin to yang, it takes time for the climate to catch up. Imagine driving a car at 75 miles per hour (I apologize to you all who use the metric system – I’m metric impaired). If you want to stop and go in reverse, first you have to hit the brakes. However, if you hit the brakes really hard, that car is going to continue skidding forward for quite a distance before you can start moving in the opposite direction. Thus, even though the brakes have been put on the Yin movement of the year, before we can really move towards the Yang we continue “skidding” colder and colder for awhile, before Spring truly warms up the Earth.

The health maintenance guideline for this season is similar to Winter Solstice. Specifically, during Minor Cold we should focus on (1) Nourishing the Kidney (Yang Shen 養腎), and (2) Safeguarding the Spleen and Stomach (Baohu Pi Wei 保護脾胃). Winter is the time for all the Qi to be stored away internally – my Neijing students will remember this discussion from Su Wen Chapter 2. Since Kidney is the root of storage, and the root of Earlier Heaven (先天) Qi, we nourish the Kidney to nourish the body’s ability to store Qi away (i.e., the movement of Winter – 藏). While Kidney is the Earlier Heaven root, the Spleen and Stomach are the Later Heaven (後天). So, protecting the Later Heaven helps to ensure that Earlier Heaven is not excessively tapped into. This is especially important for our patients with conditions of vacuity (especially either Kidney or Middle Jiao vacuity), or patients with cold conditions (for example patients with chronic arthritic conditions – Bi syndrome from Wind, Cold and Damp).

Continue having patients get to bed early. Also encourage warming therapies such as moxibustion, especially on points like Zu San Li ST-36, Guan Yuan Ren-4, Qi Hai Ren-6, and Huo Fu Hai 33.07. Patients who have long term Bi syndrome can do daily acupressure on Feng Fu Du-16. This is a special technique from the famous Chinese acupuncturist He Puren.

In addition to the acupressure mentioned above, consider using the Leg Nine Miles Dao Ma Group (足九里) from Tung’s system. This is one of the best groups to use for Bi syndromes when multiple areas of the body are affected, or when we’re not quite sure where to start with a patient. The three points in this group are Middle Nine Miles, Upper Nine Miles, and Lower Nine Miles (88.25, 26, 27), with the middle point overlapping Feng Shi GB-31. Patients can be taught to do Paida (拍打) in this area as a daily health maintenance regimen.

Dietary guidelines for Minor Cold are similar to Winter Solstice. Since we want to protect the Middle Jiao in particular, the first basic guideline is to eat foods that are easy to digest and take foods at regular intervals. Since most of us are coming out of holidays with lots of eating going on, it’s also a good idea to cut back on intake of meats and other heavier foods.

Patients with overall yang vacuity should consume yang warming foods such as lamb, venison, alcohol (in small quantities), and warming spices like cinnamon. Meats can be taken in moderation, but moderation is important. Traditional Chinese lists would add dog meat to the “should” list, but I have to admit that’s way out of my cultural comfort zone! These same patients should avoid cold foods such as duck, rabbit, chrysanthemum, mint, milk or yoghurts. Patients who are prone to cold damp conditions (such as arthritic patients) should do the same as already mentioned and especially avoid cold-damp producing foods such as oranges and orange juice, tropical fruits, and the overconsumption of refined sugars.

Instead of a traditional dietary recipe for this node I’ll offer readers a medicated wine. This formula is specifically for the treatment of Bi syndromes due to cold in the channels, and can be taken by patients over the age of 40 for the prevention of joint problems as well. The recipe is actually given to us by Tung in his original text from 1973. While he was an amazing acupuncturist, like all doctors in China, he was familiar with a number of Chinese medicine therapies (including the basic use of herbal medicines).

Ingredients:

• Huang Qi 1 30g

• Wu Jia Pi 30g

• Placenta (powdered) 1.5g

• Ge Jie 1 piece

• Chuan Niu Xi 9g

Place all the herbs in an appropriate amount of grain alcohol (e.g., vodka), and let soak for about 1 month. Then, so consume about 1 shot per day or as otherwise needed. For patients with ongoing, active Bi syndrome pain, I suggest combining with external liniments (跌打酒). We did a class through eLotus in August 2019 on Tung’s acupuncture and external herbs for injury management (click here for more information on that class).

I hope everyone had a great New Year. Stay warm!

Henry

Winter Solstice 冬至 Seasonal Node

Last year as I wrote my blog post for Winter Solstice I couldn’t have imagined what the year would bring, and I’m sure I’m not alone in that sentiment. Solstice is the original Winter holiday, that which is the basis for why other holidays – Christmas, Julian Calendar New Year, Hanukah, Saturnalia – are celebrated this time of year. Solstice is the promise of new life and life renewing itself. It is post tenebras lux. It is the literal as well as metaphorical return of light. After this year, with worsening pandemic and threats of the unthinkable martial law in the United States, this turning towards hope and life is even more meaningful.

In 2020 the astronomical Winter Solstice arrives at 5:02am (Eastern Standard Time) on Monday December 21, and this same day starts the Winter Solstice Seasonal Node. This is the moment when the elliptical orbit of the sun reaches the point where, because of the tilt of the planet, the sun’s rays hit the Tropic of Capricorn at 90 degrees. This angling of the planet towards the sun means the least hours of daylight for the northern hemisphere out of any day of the year, and in the most northern latitudes there is 24 hours of darkness. However, after today the Earth’s path around the sun changes such that the tilted northern hemisphere will gradually be hit more directly by the sun’s rays, slowly making the days longer and the warmer. Appropriately, in the Chinese almanac, this year Monday the 21st is an “Open” day, meaning it is auspicious for most activities.

The Chinese term for Winter Solstice (dong zhi 冬至) literally means the “extreme of Winter” (the most Yin season), and symbolically this node is represented by Hexagram 24, which is comprised of one Yang line at the bottom of 5 Yin lines. Hexagram 24’s name is Return – Fu (復). What is returning? The Yang and the light are returning. One of the basic laws of Yin-Yang theory is that of mutual transformation. When something reaches an extreme, then it naturally reverts to the opposite. Now is when Yin has reached its extreme thereby giving birth to Yang. The smaller segments, the Material Manifestations, for this node are Earthworms Congeal (Qiu Yin Jie 蚯蚓結), Moose Deer Shed Their Horns (Mi Jiao Jie 麋角解), and Aquifers Stir (Shui Quan Dong 水泉動).

During Winter Solstice we should consider the Chinese folk saying, “Dong zhi yang sheng you da dao, xia bing dong zhi shi miao zhao” (冬至養生有大道，夏病冬治是妙招) – “Nourishing life at Winter Solstice is a great Dao, treating summer’s disease in winter is very clever!” (Yes… It rhymes better in Chinese…) What can we do then to stay healthy during this time period? The first basic recommendation is “Zao shui, wan qi” (早睡晚起) – go to bed early and sleep late. Winter is the time of year that is most yin, and ideally we should sort of be hibernating, both physically and mentally. Finding more time for rest and reflection puts us into harmony with the Yin of Winter.  That said, too much sleep is also not great. Sleep (which is Yin) when excessive damages the Yang, which is why the Su Wen says excessive sleep (literally, lying down) injures the Qi (久臥傷氣). The recommendation I typically give patients is that 7-8 hours of sleep is plenty for the average healthy person.

The second recommendation is “Chi xu yun dong” (持續運動) – persist in moving. Even though Winter is the time of yin quietude, as mentioned above the Winter Solstice marks the birth of yang.  Because movement is Yang it is important for us to “persist in moving” during this time of year. Appropriate exercises include gentle movement such as Taiji, Qigong or Yoga. 

To stay healthy this time of year there are also some things to avoid. Since this time of year has an abundance of Yin influences (i.e., the cold and dark) and a lack of Yang, the first admonition is to guard against weakening the Yang Qi. As Winter Solstice is the time of Yang Qi’s birth in the natural world, it is important to be sure that there is adequate Yang Qi in the body. For patients with Qi Vacuity cold it is especially important to avoid excess cold exposure. This is a time period where those patients can apply moxibustion at home on points such as Qi Hai REN-6, Guan Yuan REN-4, or Zu San Li ST3-6. Alternately, they can do moxibustion on Tung’s point Huo Fu Hai 33.07. Another traditional recommendation for this time of year is to try exposing oneself to sunlight as much as possible. If possible, traditional medicine recommends allowing the back to be exposed to the sun, and this can be done inside a warm room with large windows. Why the back? In Chinese medicine the back is seen as Yang while the anterior of the body Yin. Warming the back is a way to warm and strengthen the Tai Yang (greater Yang) channel, and in general the Yang of the entire body.

The second thing to be cautious of during Winter Solstice is excessive “bedroom activity.” Since Winter is the time of storage, a traditional recommendation for the season is to guard our sexual vitality. Jing essence is the stored and most precious form of Yang Qi, and is stirred during sex. Hence Chinese medicine suggests guarding against excessive sexual activity in Winter. However, we should be careful to not read this only literally. More broadly, sexual activity is a metaphor for expending our essence on all levels. This is why in many cultures around the world this time of the year is the time of reflection and planning for the next year to come. It is a time to step back and move inwards rather than to expend our vitality outwards.

In terms of diet, this is the time of the year to eat more foods that help supplement the Kidney and Spleen, such as rice congees, lamb, beef, shan yao (nagaimo), and winter squash. It is also appropriate to eat a small amount of mildly acrid foods such as fresh ginger, scallions and black pepper (to help keep things moving and to birth yang). Try to avoid cold foods in general, or foods that are difficult to digest such as greasy, raw, or very spicy foods. This is especially so for those patients who tend towards Spleen and qi vacuity patterns.

Here’s a traditional recipe for Winter Solstice:

Longan and Lamb Soup 龍眼羊肉湯

Ingredients:

• 1 lb. Lamb (deboned and cut into chunks)

• Dried longan fruit (龍眼肉) 15g

• Fresh ginger (peeled and sliced) about 20g

• Scallions (chopped)

• Salt

• Cooking wine

 Cooking Instructions:

1. Put lamb in a pot with 3 cups water, bring to a boil and simmer for just about 2 minutes; strain out lamb and discard water to remove the fat

2. Place lamb back into pot with enough water to completely cover the meat (6-8 cups), the sliced ginger and scallions, dried longan, and a small amount of cooking wine

3. Bring to a rapid boil on high flame, then reduce flame to a low simmer and cook for about 2 hours; remove from heat and add salt to taste

This recipe warms the interior and builds Qi and blood, and nourished the Heart to quiet the Spirit.

In the north of China there is a long tradition of eating dumplings around Winter Solstice. In Japan, where dong zhi is pronounced tōji (とうじ), a common tradition is to take baths in water scented with Yuzu citrus. One of the foods of choice in Japan is kabocha, where it is commonly stewed together with adzuki beans to create a dish called itokoni (いとこ煮). The red color, as a symbol of Yang, is thought to ward off evil and confer good luck.

The Gallbladder and Winter Solstice 

Yes, the Gallbladder channel has a lot to do with Winter Solstice, yet in my experience even many Chinese medicine practitioners are slow to make this connection. In Chinese medicine there are 12 main channels in the body, each linked with an internal organ. These 12 channels are also associated with the 12 watches (時辰), the 12 two-hours time periods that make up the day in the traditional Chinese method of counting time. Since there are 12 months in the year, the 12 watches of the day correspond each to one of the months. The Gallbladder channel is associated with the time 11pm – 1am, the Zi (子) hour. This time of day, because it is a Water phase earthly branch, is the time that goes with the second month of Winter, the month of the Winter Solstice.  

This helps us see the Gallbladder channel in a new and interesting light. One of the things I mention when I teach is that we, as Chinese medicine practitioners, eventually need to deepen our understanding of Chinese medicine beyond the very basic things we memorize in our initial training. I think our inability to do this is what leads some to eventually adopt all sorts of supplementary ideas (let’s all do muscle testing, tuning forks, or use a pendulum to decide what herbs are good for a patient, as examples) that have nothing to do with Chinese medicine. For me, Chinese medicine is deep enough and rich enough of a medical system in its own right that not even 5 lifetimes would be enough to really study all of it!

So, back to the Gallbladder… In school we all memorize a Five Phase association with each of the organs and channels, but this is just the beginning of understanding the complexity of these theories (special thanks to Heiner Fruehauf for opening my eyes to looking at the channels in this layered way). To start then, we know that the Gallbladder is a Wood Phase channel. But that’s only step one!

As I just mentioned above, the Gallbladder is associated with the Zi Hour (11pm-1am), the time also associated with the second month of Winter and the Winter Solstice. This time of day is a Water time of day (not a Wood time of day). Thus, the Gallbladder channel, while primarily Wood in nature, also has a Water association. This helps us understand why the Jing Mai chapter of the Ling Shu (LS10) says that the Gallbladder channel governs disorders of bones, and why the Gallbladder is one of the Six Extraordinary Fu, and a Fu that stores clear essence (清精之腑).  

In addition to the Water and Wood associations, Gallbladder is also a Fire organ. Why? The Gallbladder is the Shao Yang. Each of the six channel families is associated with one of the Five Phases, and the Shao Yang specifically has a Fire association. The Shao Yang is also one of the pivot channels (the Yang pivot channel), meaning it is also symbolic of the Winter Solstice – the time of year where all of nature pivots towards Yang.  

Now, the theory is interesting but in the end if it has no practical application to medicine for us it is of no use. The Gallbladder association with Wood, Water and Fire though actually clarifies why some points on this channel actually do what they do. Let’s take Tung’s Nine Miles Dao Ma Group. The main point of the group, Middle Nine Miles (88.25 Zhong Jiu Li 中九里) overlaps Feng Shi GB-31. In Tung’s acupuncture one of the things this point treats commonly is pain (in multiple parts of the body). The Wood phase partly deals with the smooth movement of Qi and Blood in the body, and the Shao Yang as the pivot has the same function. The Gallbladder channel having a Water (and a bone) association then helps us understand why Middle Nine Miles is indicated for bone spurs (i.e., a type of stagnation at the level of bones).

Lastly, “lack of strength in the nerves” (神經衰弱) is an important indication for Middle Nine Miles. This term is actually a psychological symptom, often translated as the now out-dated term neurasthenia. Neurasthenia included a wide range of presentations such as insomnia, fatigue, depression and a wide range of anxiety based disorders. As we said above, the Gallbladder as the Shao Yang has a Fire association. Furthermore, we know that the Shao Yang communicates with the Shao Yin (Heart), the other pivot channel. The close connection with the Fire and Heart illustrates the use of this point in treating Shen-spirit disorders. This is why in my clinic the stressed-and-tired Winter Solstice treatment is the combination of Middle Nine Miles with the Lower Three Emperors (77.17/18, 19, 21), one of the main point groups for the Kidney.

Obviously there’s a lot more exploration we can do for any channel – looking at the other channel connections, names of points, etc… One of my resolutions for the coming year (and I encourage everyone else to do the same) is to try as hard as possible to look more and more deeply at Chinese medicine so we can better understand the system and how to use it in the clinic.

Happy Solstice!

Great Snow 大雪 Seasonal Node

The Great Snow seasonal node starts today, December 7th. While we don’t have snow right now here in New Jersey, I think the best way we should look at the names of this and the last seasonal node is figuratively. Certainly, in some places by now there is snow, but most of the snowiest weather in the Northeast US will most likely come later in the season. Right now what we do have is a dramatic turn towards much colder weather, and because of that we are in the time of year with the potential for real snow. Tonight in New Jersey the temperatures are going to dip into the 20s (that is below 0 Celsius), meaning our outdoor Taiji classes will be cold! In my opinion, this is the best way we can think of the nodes’ names – the potential for snow as a symbol for the seasonal change we are experiencing right now.

Great Snow is the last Seasonal Node before Winter Solstice, representing the final stage of the most Yin time of year and symbolized by the hexagram Kun 坤, composed entirely of Yin (broken) lines. The two weeks of Great Snow are the longest nights of the year, culminating with the Solstice after which days will slowly be getting longer again. The Material Manifestations for Great Snow are Spangled Drongos Cease to Sing (He Dan Bu Ming 鶡旦不鳴), Tigers Begin to Mate (Hu Shi Jiao 虎始交), and Water Irises Grow (Li Ting Sheng 荔挺生).

The main way to guard health in this period is to focus on warm supplementation, while at the same time avoiding exposure to cold. Thus the Neijing tells us during Winter it is appropriate to “avoid the cold and seek warmth” (去寒就溫).  Along these lines people can continue practices such as preventive moxibustion on points like Qi Hai REN-6, Guan Yuan REN-4 and Zu San Li ST-36. Another guideline from the Huang Di Nei Jing for the Winter is to “Nourish Yin” (秋冬養陰). While this may seem counterintuitive for the cold time of year, the meaning of ‘Yin’ in this passage refers to the body’s ability to store, and thereby regenerate, its vitality. Yin means being able to be in a state of quite, rest and solitude. Therefore, during this Seasonal Node try to get more sleep, attempting to get into bed earlier. Sleep is one of the best Chinese medical prescriptions for supplementing the Qi and strengthening the Kidney!

In terms of Tung’s acupuncture, Nourishing Yin (in other words, nourishing consolidation and containment) means we should focus on Zones 7 and 8 on the legs. The point groups that will focus on Kidneys, the organ of the season, are the Lower Three Emperors (Xia San Huang 下三皇), and the Penetrate Kidney Three Needles (Shen Tong San Zhen 腎通三針). These points are easily and quite effectively combined with the moxibustion suggestions above. Over the next several blog posts my goal is to start giving more specific recommendations about Tung’s points and treatment strategies for each of the nodes.

Aside from acupuncture and moxibustion, medicated wines have a long tradition of use in Chinese medicine. They are a cost effective way to take a small dose of expensive or hard to find herbs, and alcohol itself is a preservative to stretch the shelf life of medicinal products. Since alcohol is warm, acrid and sweet by nature, it has the ability to warm and expel cold, and supplement the Qi and Blood while also circulating them. Thus, medicated wines are appropriate for Winter. One traditional medicated wine that is prepared during Great Snow is Gecko Wine (Ge Jie Jiu 蛤蚧酒). To prepare, soak one pair of Gecko (ge jie 蛤蚧) obtained from a Chinese pharmacy in 1000ml of grain alcohol of at least 80 proof (vodka is a good choice). Let sit for at least 1 month, and then take 1 small shot glass per day in the evening. Gecko has a Yang warming and Kidney supplementing effect. Along the lines now of incorporating more Tung points in these posts, here’s a quiz for readers… What Tung point closely mimics the herb Ge Jie? We’ll talk about this in an upcoming post!

In addition to medicated wines this is the time of year to eat warming, and especially Kidney supplementing, foods. Although many people think of Chinese herbs as the main way to supplement Kidneys, in Chinese there is a saying, “medicinal supplementation cannot be as good as supplementing with food” (cao bu bu ru shi bu 藥補不如食補). Foods appropriate for Great Snow include lamb, beef, chicken, venison, shrimp, and mussels. In addition to these animal products, foods to emphasize this Seasonal Node are walnuts, almonds, or other nuts, and warming spices such as ginger and cinnamon. Since this time of year can be cold and dry it is appropriate to cook soups or stews as they are both warming and moistening. Sipping warm water throughout the day is also an excellent recommendation for people who feel dry (i.e., our patients with Blood or Yin vacuity). Now is the time of year to continue using root vegetables such as yams or turnips that traditionally could be kept in cold storage for Winter consumption.

While warming foods are good for the season, the pitfall is overconsumption creating too much heat and stagnation in the digestive system. As such, if possible this time of year we should consume some foods that help gently clear heat, open the Stomach, and descend yang (to consolidate it).  In that vein, one traditional vegetarian recipe for Great Snow is Garlic Chrysanthemum Greens.

Garlic Chrysanthemum Greens (蒜泥茼蒿)

Ingredients:

• Edible chrysanthemum greens (Tong Hao 茼蒿) ½ lb.

• 1 small garlic bulb

• Sesame oil

• Salt and pepper to taste

Directions:

1. Rinse chrysanthemum greens and chop into 1 inch pieces

2. Peel, crush then chop garlic

3. Bring a pot of salted water to boil, then blanch chrysanthemum greens by immersing in water for about 3 minutes; then drain

4. Mix greens with chopped garlic, and a small amount of salt, peper and sesame oil to taste; serve slightly warm or room temperature

This recipe loosens the center, rectifies Qi, disperses accumulated food and opens the Stomach. 

Stay warm and happy Winter!